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Rathert C, Mittler JN, Vogus TJ, Lee YSH. What matters to you? An observational field study of patient and care provider expectations for health care relationships. PLoS One 2024; 19:e0304854. [PMID: 38954686 PMCID: PMC11218989 DOI: 10.1371/journal.pone.0304854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 05/21/2024] [Indexed: 07/04/2024] Open
Abstract
Therapeutic connections (TC) between patients and providers are foundational to patient-centered care, which is co-produced between patients and care providers. This necessitates that we understand what patients expect from TCs, the extent to which providers know what patients expect, and what providers expect. The purpose of this study was to examine nine TC dimensions and determine which are most important to patients, which dimensions providers believe are most important to patients, and which are most important to providers. An online survey of patients (n = 388) and care providers (n = 433) was conducted in the USA in March 2021. Respondents rated the extent to which the nine TC dimensions were important to them, followed by open-ended questions to expand upon what matters. The quantitative responses were rank-ordered and rankings were compared across groups. All groups ranked "having the patient's best interest in mind no matter what" as the top expectation. Patients also ranked "caring commitment" and being "on the same page" as highly important. Providers were relatively accurate in ranking what they believed was most important to patients. Respondents affirmed the TC dimensions in the qualitative results, adding nuance and context, such as patients feeling "heard" and noting providers that go "above and beyond." Providers ranked dimensions differently for themselves, prioritizing "full presence" and "emotional support" of patients. This study is among the first to examine expectations for TC. TC could play an explanatory role in understanding variation in patient experience ratings and other outcomes.
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Affiliation(s)
- Cheryl Rathert
- Department of Health Management and Policy, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, United States of America
| | - Jessica N. Mittler
- Department of Health Administration, College of Health Professions, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Timothy J. Vogus
- Department of Organizational Studies, Owen Graduate School of Management, Vanderbilt University, Nashville, TN, United States of America
| | - Yuna S. H. Lee
- Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY, United States of America
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Lai AY, Wee KZ, Frimpong JA. Proactive behaviors and health care workers: A systematic review. Health Care Manage Rev 2024; 49:239-251. [PMID: 38757911 DOI: 10.1097/hmr.0000000000000409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
BACKGROUND Proactive behaviors at work refer to discretionary actions among workers that are self-starting, change oriented, and future focused. Proactive behaviors reflect the idiosyncratic actions by individual workers that shape the delivery and experience of professional services, highlight a bottom-up perspective on workers' agency and motivation that can influence organizational practices, and are associated with a variety of employee and organizational outcomes. PURPOSE This systematic review aims to understand the various forms of proactive behaviors in health care workers that have been studied, and how these proactive behaviors are associated with employee-level outcomes and quality of care. METHODS Systematic review of articles published to date on proactive behaviors in health care workers. RESULTS Based on the identification of 40 articles, we find that job crafting, active problem solving, voice, extra-role behaviors, and idiosyncratic deals have been investigated as proactive behaviors among health care workers. Among these, job crafting is the most commonly studied (35% of articles), and it has been conceptualized and measured in the most consistent way, including as individual- and group-level phenomena, and as organizational interventions. Studies on active problem solving, which refers to workers accepting responsibility, exercising control, and taking action around anticipated or experienced problems at work, have not been consistently investigated as a form of proactive behavior but represent 25% of the articles identified in this review. Overall, this review finds that proactive behaviors in health care is a burgeoning area of research, with the majority of studies being cross-sectional in design and published after 2010, and focused on workers' job satisfaction as the outcome. PRACTICE IMPLICATIONS Health care workers and managers should consider the distinct influences and contributions of proactive behaviors as ways to improve employee-level outcomes and quality of care.
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Chen H, Liu C, Wu K, Liu CY, Chiou WK. The effects of loving-kindness meditation on doctors' communication anxiety, trust, calling and defensive medicine practice. Biopsychosoc Med 2024; 18:11. [PMID: 38730309 PMCID: PMC11088149 DOI: 10.1186/s13030-024-00307-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/25/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVE The study investigated the effects of loving-kindness meditation (LKM) on doctors' communication anxiety, trust, calling, and defensive medicine practice. METHODS This study recruited 94 doctors from a hospital in China, randomized them to an LKM group (n = 47), and waited for the control group (n = 47). The experimental group accepted an 8-week LKM interference while the waiting for the control group underwent no interference. Researchers measured four major variable factors (communication anxiety, trust, calling, and defensive medicine practice) before and after the LKM intervention. RESULTS In the experimental group, trust, and calling were significantly higher, and communication anxiety, and defensive medicine practice were significantly lower than in the control group. In the control group, there were no noticeable differences in any of the four variables between the pre-test and post-test. CONCLUSIONS The results of this study demonstrate that LKM may help to improve trust, and calling, and reduce communication anxiety and defensive medicine practice. The finding of LKM's effect extends the understanding of the integrative effects of positive psychology on the decrease of defensive medicine practice. TRIAL REGISTRATION ChiCTR2300074568. Registered in Chinese Clinical Trial Registry (ChiCTR), 9 August, 2023.
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Affiliation(s)
- Hao Chen
- School of Film Television & Communication, Xiamen University of Technology, Xiamen, China
- Business Analytics Research Center, Chang Gung University, Taoyuan, 33302, Taiwan
| | - Chao Liu
- School of Journalism and Communication, Hua Qiao University, Xiamen, 361021, China
- Business Analytics Research Center, Chang Gung University, Taoyuan, 33302, Taiwan
| | - Kan Wu
- Business Analytics Research Center, Chang Gung University, Taoyuan, 33302, Taiwan
| | - Chia-Yih Liu
- Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Wen-Ko Chiou
- Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
- Department of Industrial Engineering and Management, Ming Chi University of Technology, New Taipei, Taiwan.
- Department of Industrial Design, Chang Gung University, Taoyuan, Taiwan.
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Fusco F, Marsilio M, Guglielmetti C. Co-creation in healthcare: framing the outcomes and their determinants. JOURNAL OF SERVICE MANAGEMENT 2023. [DOI: 10.1108/josm-06-2021-0212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PurposeUnderstanding the outcomes of co-creation (CC) in healthcare is increasingly gaining multidisciplinary scientific interest. Although more and more service management scholars have pointed out the benefits of cross-fertilization between the various research fields, the literature on this topic is still scattered and poorly integrated. This study aims to summarize and integrate multiple strands of extant knowledge CC by identifying the outcomes of health CC and the determinants of these outcomes and their relationships.Design/methodology/approachA structured literature review was conducted per PRISMA guidelines. A total of 4,189 records were retrieved from the six databases; 1,983 articles were screened, with 161 included in the qualitative thematic analysis.FindingsThis study advances a comprehensive framework for healthcare CC based on a thorough analysis of the outcomes and their determinants, that is, antecedents, management activities and institutional context. Extant research rarely evaluates outcomes from a multidimensional and systemic perspective. Less attention has been paid to the relationship among the CC process elements.Research limitations/implicationsThis study offers an agenda to guide future studies on healthcare CC. Highlighting some areas of integration among different disciplines further advances service literature.Practical implicationsThe framework offers an operational guide to better shape managerial endeavors to facilitate CC, provide direction and assess multiple outcomes.Originality/valueThis is the first extensive attempt to synthesize and integrate multidisciplinary knowledge on CC outcomes in healthcare settings by adopting a systematic perspective on the overall process.
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Borde PS, Arora R, Kakoty S. Transformational health-care leaders in collaborative entrepreneurial model to achieve UNSDG: a qualitative study. Leadersh Health Serv (Bradf Engl) 2022; ahead-of-print. [PMID: 36087046 DOI: 10.1108/lhs-03-2022-0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The agglomeration of specialist health-care facilities has often been restricted to metropolitan areas. This study aims to understand how health-care professionals with transformational leadership behaviors and entrepreneurial aims with a similar vision and expertise play pertinent roles in providing essential specialized health care in rural and semi-urban areas and achieving the United Nations Sustainable Development Goals (UNSDGs). DESIGN/METHODOLOGY/APPROACH Qualitative synthesis using focused-group discussions and interviews was conducted in a phased manner. For this, this study has used stakeholder-theory, and dynamic-capabilities approaches. FINDINGS This study explores the intricacies of collaborative entrepreneurship (CE)-based health-care ventures in developing regions and reveals five pertinent attributes: strategic control, synergy, commitment, empathy and satisfaction. This study recommends that entrepreneurial collaboration, especially by transformational health-care leaders, can significantly contribute to creating an endogenous health-care ecosystem with advanced facilities and technology-enabled modern infrastructure and augmenting regional development. RESEARCH LIMITATIONS/IMPLICATIONS This study was conducted in semi-urban settings in India. Future research should include other sectors and regions to generalize the findings. PRACTICAL IMPLICATIONS This study benefits health-care professionals having an analogous vision, skills and entrepreneurial aims. SOCIAL IMPLICATIONS Collaboration of health-care professionals and using transformational leadership behaviors can considerably contribute to providing specialist health care in developing areas and enhance patient satisfaction. ORIGINALITY/VALUE To the best of the authors' knowledge, this is the first study to discuss the importance of CE in health care in developing areas. In addition, it discusses the benefits of the CE model in achieving the UNSDGs and offers valuable suggestions for health-care professionals and administrators.
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Affiliation(s)
- Prashant Sunil Borde
- Department of Organization Behaviour and Human Resources, Indian Institute of Management Shillong, Umsawli, India
| | - Ridhi Arora
- Department of Organization Behaviour and Human Resources, Indian Institute of Management Shillong, Umsawli, India
| | - Sanjeeb Kakoty
- Department of Organization Behaviour and Human Resources, Indian Institute of Management Shillong, Umsawli, India
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Gallan AS, Helkkula A. Cocreating transformative value propositions with customers experiencing vulnerability during humanitarian crises. AMS REVIEW 2022. [PMCID: PMC8938739 DOI: 10.1007/s13162-022-00223-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
To understand the cocreation and impact of transformative value propositions (TVPs), which are designed to address vulnerabilities that customers experience because of humanitarian crises, this study applies a typology of service innovation archetypes as a domain theory to examine different ways to cocreate TVPs. The authors identify different types of customers who experience vulnerability, using a social determinants of health (SDOH) framework. Exemplary TVPs reveal how service organizations can alleviate customer vulnerabilities, in the short and long terms, and highlight a distinction between TVPs that require incremental changes to existing resource deployment versus those that require novel capabilities. This article contributes to transformative service research by establishing a value-centric model that relates the cocreation of TVPs to customers experiencing vulnerability. In turn, researchers and managers can identify the output-based, process-based, experiential, and systemic changes needed to cocreate TVPs.
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Affiliation(s)
- Andrew S. Gallan
- Florida Atlantic University, 777 Glades Road, Fleming Hall 209, Boca Raton, FL 33431 USA
| | - Anu Helkkula
- Centre for Relationship Marketing and Service Management, Hanken School of Economics, Arkadiankatu 22, 00100 Helsinki, Finland
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Bradshaw J, Siddiqui N, Greenfield D, Sharma A. Kindness, Listening, and Connection: Patient and Clinician Key Requirements for Emotional Support in Chronic and Complex Care. J Patient Exp 2022; 9:23743735221092627. [PMID: 35434291 PMCID: PMC9008851 DOI: 10.1177/23743735221092627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Emotional support for patients is critical for achieving person-centered care. However,
the literature evidences an ongoing challenge in embedding emotional support within
current health services. This study aimed to investigate the strategies to embed emotional
support from the perspectives of patients and clinicians. This is an exploratory
qualitative study that collected data through focus group discussions (FGDs) and
interviews from 11 patients, 2 carers, and 7 clinicians in the multi-disciplinary care
teams in an outpatient complex and chronic care setting in New South Wales, Australia. The
FGDs and interviews were recorded, transcribed, and thematically analyzed. Three main
themes emerged from the experience of both the patients and clinicians: (1) warmth and
kindness, (2) deep listening, and (3) social connection in the process of treatment.
Clinicians’ and patients’ shared experience of these themes was key to embed emotional
support in care. Practical strategies including promoting shared understanding of
emotional support, enhancing provider's capability to deliver emotional support, and
building patient's networking opportunities in treatment processes were discussed to
facilitate emotional support in patient care and health services.
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Affiliation(s)
- Jane Bradshaw
- University of Tasmania, Health Service Management School of Business & Economics, Sydney, Australia
- Be Pain Smart Service, Royal Rehab, Ryde, Australia
| | - Nazlee Siddiqui
- University of Tasmania, Health Service Management School of Business & Economics, Sydney, Australia
| | - David Greenfield
- UNSW Simpson Centre for Health Services Research, Sydney, Australia
- University of New South Wales Southwestern Sydney Clinical School, Liverpool, Australia
| | - Anita Sharma
- Nepean Blue Mountains Local Health District, Western Sydney, Australia
- Nepean Clinical School, University of Sydney, Sydney, Australia
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Lunn ML, Ellinger AD, Nimon KF, Halbesleben JR. Chief Executive Officers' Perceptions of Collective Organizational Engagement and Patient Experience in Acute Care Hospitals. J Patient Exp 2021; 8:23743735211034027. [PMID: 34395847 PMCID: PMC8361540 DOI: 10.1177/23743735211034027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The concept of employee engagement has garnered considerable attention in acute care hospitals because of the many positive benefits that research has found when clinicians are individually engaged. However, limited, if any, research has examined the effects of engaging all hospital employees (including housekeeping, cafeteria, and admissions staff) in a collective manner and how this may impact patient experience, an important measure of hospital performance. Therefore, this quantitative online survey-based study examines the association between 60 chief executive officers' (CEOs') perceptions of the collective organizational engagement (COE) of all hospital employees and patient experience. A summary measure of the US Hospital Consumer Assessment of Healthcare Providers and Systems survey scores was used to assess patient experience at each of the 60 hospitals represented in the study. A multiple linear regression model was tested using structural equation modeling. The findings of the research suggest that CEOs' perceptions of COE explain a significant amount of variability in patient experience at acute care hospitals. Practical implications for CEOs and other hospital leaders are provided that discuss how COE can be used as an organizational capability to influence organizational performance.
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Affiliation(s)
- Mary Lynn Lunn
- Tulane University, Freeman School of Business, New Orleans, LA, USA.,The University of Richmond, Robins School of Business, Richmond, VA, USA
| | - Andrea D Ellinger
- The University of Texas at Tyler, Soules College of Business, Tyler, TX, USA
| | - Kim F Nimon
- The University of Texas at Tyler, Soules College of Business, Tyler, TX, USA
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Johannessen DA, Nordfjærn T, Geirdal AØ. Work-Related Satisfaction among Clinicians Working at Inpatient Treatment Facilities for Substance Use Disorder: The Role of Recovery Orientation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147423. [PMID: 34299874 PMCID: PMC8303105 DOI: 10.3390/ijerph18147423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 07/07/2021] [Accepted: 07/09/2021] [Indexed: 12/30/2022]
Abstract
Several psychosocial factors have been suggested as facilitators of change among inpatients treated for substance use disorder (SUD). Research suggests that staff members are also influenced by the practice in which they are involved, and by contextual psychosocial factors at their treatment facilities. This cross-sectional questionnaire survey study was conducted to investigate the role of recovery-orientated interventions in describing work-related satisfaction among clinicians at inpatient SUD treatment facilities. The respondents (n = 407) rated items indicating work-related satisfaction and the degree of recovery orientation at their treatment facilities. The main findings of two block regression analyses indicated that clinicians’ work-related satisfaction was positively influenced by inpatients’ opportunities to pursue their goals and choices, and negatively influenced by inpatient involvement. The change in clinicians’ work-related satisfaction could not be described by the degree of individually tailored and varied interventions at the treatment facility. Clinicians should be supported and involved in the process of implementing measures to increase inpatient involvement in the treatment programmes, and treatment measures that enable inpatients to pursue their goals and choices should be enhanced. The findings of this and previous studies indicate that a recovery-oriented framework promotes clinicians’ work-related satisfaction and has an enabling influence on both inpatients and clinicians.
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Affiliation(s)
- Dagny Adriaenssen Johannessen
- Blue Cross East, 0182 Oslo, Norway
- Department of Social Work, Child Welfare and Social Policy, OsloMet—Oslo Metropolitan University, 0130 Oslo, Norway;
- Correspondence:
| | - Trond Nordfjærn
- Department of Psychology, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway;
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olavs University Hospital, 7006 Trondheim, Norway
| | - Amy Østertun Geirdal
- Department of Social Work, Child Welfare and Social Policy, OsloMet—Oslo Metropolitan University, 0130 Oslo, Norway;
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