Improving health care quality: the implementation of whistleblowing

Recognizing the legacy of the TQM Journal: a bibliometric analysis of Scopus indexed publications (2008 - 2021)

Purpose

The purpose of this paper is to examine the trends in research published by the TQM Journal since its indexing in the Scopus database in 2008. The paper intends to offer a bibliometric analysis of the TQM Journal by highlighting the contributions made by the journal through citations, prominent authors, most frequent keywords and publications across geographical regions.

Design/methodology/approach

The study involved the use of descriptive and visual methods to examine the quantitative and qualitative features of the bibliometric data. The authors made use of Biblioshiny using R-Studio and VoS viewer user interfaces to perform various types of bibliometric analysis on the bibliomteric data of the journal extracted from Scopus database (the largest inter-disciplinary database in social sciences).

Findings

With 85% of cited documents having a total 12,079 citations, the TQM Journal is one of the most reputed and impactful journals in the field of performance, integrated management system total quality management and allied concepts. The publications in the TQM Journal have cited many top-rated journals relevant to the domain. Maximum contributions in TQM Journal are submitted by authors from Italy, India and UK. Major submissions made to TQM Journal have focused on the quality concepts relevant to production and manufacturing sector in particular. In this regard, the TQM Journal has a very bright scope in covering the diverse and latest trends across industries especially during pandemic and changes happening thereof. The contributions of the editorial team along with authors and reviewers are unmatchable in making the reputation of the TQM Journal.

Originality/value

To the best of knowledge of the authors, this is going to be first bibliometric study ever conducted on the TQM Journal on documents published in Scopus database. The work carried out is unique, as it is an attempt by authors to comprehend the legacy of the TQM Journal through bibliometric data and showcase the past trends and explore future directions for the TQM Journal.

"I would do something if I could!": experiences and reflections from ethics teachers on how to respond when hearing alarming cases from medical students

BACKGROUND

Previous studies show that teachers can feel disturbed by alarming cases brought up by students during their teaching activities. Teachers may feel uncertain about how to deal with these cases, as they might feel responsible to take action to prevent further harm. This study aims to explore how ethics teachers in medical schools would respond to a student report of unethical or unprofessional behaviour during the clinical training phase (clerkship) that is alarming and potentially harmful for patients or students themselves.

METHODS

This study used qualitative methods with purposive sampling. We conducted in-depth interviews with 17 teachers from 10 medical schools in Indonesia. We asked if they had heard any alarming and harmful cases from students and provided two cases as examples.

RESULTS

Four teachers shared their own cases, which they perceived as disturbing and alarming. The cases included power abuse, fraud and deception, violation of patient's rights and autonomy, and sexual harassment. Regarding teachers' responses in general, we found three main themes: (1) being assertive, (2) being careful, (3) barriers and facilitators. Most teachers were convinced of the need to take action despite numerous barriers, which they identified, leading to doubts and concerns in taking action. Our study shows that formal education in ethics might not necessarily influence how teachers respond to alarming cases, and that their responses are mainly influenced by how they perceive their role and responsibility as teachers.

CONCLUSIONS

Our study suggests that teachers should carefully consider the risks and consequences before taking action upon alarming cases to prevent further harm, and that support from higher authorities might be crucial, especially in the Indonesian context. Our study also shows that taking action as a group might be appropriate in certain cases, while personal approaches might be more appropriate in other cases. Most importantly, school leaders and administrators should develop effective organisational culture and support students and teachers for their ethical responsibility commitment.

Impact of organizational silence and favoritism on nurse's work outcomes and psychological well-being

OBJECTIVES

The study aimed to assess the impacts of organizational silence and favoritism on work outcomes and psychological wellbeing among nurses working in hospitals.

BACKGROUND

Literature on the organizational climate among nurses in hospital settings is limited, particularly on favoritism and organizational silence and their effect on nurses.

METHODS

Purposive sampling was used to gather 549 registered nurses who participated in this cross-sectional study. Standardized self-report questionnaires were used to gather the necessary data.

RESULTS

Years in the nursing profession (β = .028, P < .001), location of work (β = 0.481, P < .001), and facility size (β = 0.451, P < .001) strongly predicted organizational silence, while years in the present unit (β = 0.020, P = .022) and last shift length (β = 0.200, P = .012) predicted favoritism. Favoritism (β = 0.226, P = .028) significantly influenced turnover intention in nurses.

CONCLUSION

Higher levels of favoritism within the organization are strongly linked with nurses' turnover intention. Few individual and organizational variables predicted organizational silence and favoritism.

IMPLICATIONS TO NURSING MANAGEMENT

The results of this study provide an insight to the effects of organizational silence and favoritism towards nurses' work outcomes and psychological wellbeing. Improving the channels of communication among the healthcare team is vital to promote inclusivity among healthcare workers and enhance organizational viability.

Reporting misdemeanors in the workplace: analysing enablers using modified TISM approach

Purpose

In the scope of the immense growth of corporate frauds and scandals, reporting unethical practices could be considered as an important mechanism to control them and ultimately improve organizational quality. To this end, this study proposes the conceptual framework comprising the enablers impacting employees' tendencies and behaviors to reporting misdemeanor in the workplace.

Design/methodology/approach

Systematic review of literature has been carried out. To understand the complexities among various enablers and to analyze their driving power and contingencies, a modified total interpretive structural modeling (TISM) approach has been adopted.

Findings

The findings indicate that enablers such as moral identity (MI) and job satisfaction (JS) having higher driving power (come at the bottom of the hierarchy) are relatively more important. Furthermore, perceived personal cost (PC), moral courage (MC), self-efficacy (SE) and anger have high dependent power of factors. Finally, the paper provides two paths that can lead to whistleblower's ethical decision.

Research limitations/implications

A conceptual framework delivered in this paper requires to test against the field data. However, the conceptual understanding of driving enablers paves the way to top management in recruiting and hiring people in the workplace.

Originality/value

This study represents the first attempt to apply TISM for whistleblowing phenomenon. It provides a comprehensive conceptual framework in order to address the relative importance of various individual enablers in developing reporting tendencies against misdemeanors.

Whistleblowing over patient safety and care quality: a review of the literature

PURPOSE

The purpose of this paper is to review existing research on whistleblowing in healthcare in order to develop an evidence base for policy and research.

DESIGN/METHODOLOGY/APPROACH

A narrative review, based on systematic literature protocols developed within the management field.

FINDINGS

The authors identify valuable insights on the factors that influence healthcare whistleblowing, and how organizations respond, but also substantial gaps in the coverage of the literature, which is overly focused on nursing, has been largely carried out in the UK and Australia, and concentrates on the earlier stages of the whistleblowing process.

RESEARCH LIMITATIONS/IMPLICATIONS

The review identifies gaps in the literature on whistleblowing in healthcare, but also draws attention to an unhelpful lack of connection with the much larger mainstream literature on whistleblowing.

PRACTICAL IMPLICATIONS

Despite the limitations to the existing literature important implications for practice can be identified, including enhancing employees' sense of security and providing ethics training.

ORIGINALITY/VALUE

This paper provides a platform for future research on whistleblowing in healthcare, at a time when policymakers are increasingly aware of its role in ensuring patient safety and care quality.

Service Innovations in the Healthcare Service Ecosystem: A Case Study

In the service economy, scholars and practitioners are even more focused on the development and appliance of innovative services. The importance of service innovation is rising in many sectors and among different organizations. Several disciplines (e.g., marketing, management, operations research, etc.) deal with this innovation, a concept widely used, but with different definitions. In this paper, service innovation has been analyzed according to the Service Dominant Logic (S-D Logic) and a service ecosystem perspective. The literature still calls for a greater understanding of how a new or renewed combination of resources affects the shaping of service ecosystems. To contribute to filling this gap, this study explores the practices that different actors, enact to co-create value in novel ways; i.e., service innovation. The paper is structured as follows. In the first section, the main academic contributions on service research have been reviewed, focusing on healthcare service innovation. This is followed by the research method and discussion of the research findings. Finally, the theoretical and managerial implications have been detailed and an agenda for future research suggested. The paper offers interesting insights to develop new or renewed practices that foster the reshaping and maintaining of a healthcare service ecosystem. Some recommendations are included to support managers in the development of service innovation strategies.