Traditional vs. Contemporary Management Control Practices for Developing Public Health Policies

Optimizing Acetabular Positioning: A Comprehensive Review of Contemporary Strategies in Total Hip Arthroplasty

Total hip arthroplasty (THA) is a widely practiced surgical intervention to alleviate pain and reinstate functionality in individuals afflicted with hip joint pathology. The positioning of the acetabulum assumes paramount significance in determining the efficacy of THA, exerting profound influences on biomechanical dynamics, stability, and the durability of outcomes over time. This comprehensive review meticulously evaluates contemporary methodologies for optimizing acetabular positioning in THA, encompassing advanced technologies such as computer-assisted navigation systems, patient-specific instrumentation, robotic-assisted surgical approaches, image-based planning techniques, and intraoperative fluoroscopy. Crucially, key discoveries underscore the pivotal role of precise acetabular alignment in mitigating complications such as dislocation, component wear, and impingement. Moreover, the implications for clinical practice accentuate the imperative of continuous education and training to ensure effective deployment of sophisticated methodologies. Recommendations for furthering research and enhancing practice development underscore the necessity of scrutinizing long-term prognoses, assessing cost-effectiveness, and embracing technological innovations perpetually refining THA outcomes. Collaborative endeavors among researchers, practitioners, and industry stakeholders emerge as indispensable drivers of advancement in this domain, fostering an environment conducive to elevating the standard of care for individuals undergoing THA.

Assessing the Contribution of Managerial Accounting in Sustainable Organizational Development in the Healthcare Industry

Sustainability and digital transformation are two phenomena influencing the activities of all organizations. Managerial accounting is an essential component of these transformations, having complex roles in decision-making to ensure sustainable development through implementing modern technologies in the accounting process. This paper studies the roles of digitized managerial accounting in organizational sustainability drivers from a decision-making perspective. The empirical investigation assesses the influence of managerial accounting on the economic, social, and environmental drivers of sustainability from the perception of 396 Romanian accountants using an artificial neural network analysis and structural equation modeling. As a result, the research provides a holistic view of the managerial accounting roles enhanced by digital technologies in the sustainable development of healthcare organizations. From the accountants' perception, the leading managerial accounting roles on organizational sustainability are enablers and reporters of the sustainable value created in the organization. Additionally, the roles of creators and preservers are seen as relevant by a significant part of the respondents. Therefore, healthcare organizations must implement a sustainability vision in managerial accounting and accounting information systems using the capabilities offered by new digital technologies.

An Empirical Framework for Assessing the Balanced Scorecard Impact on Sustainable Development in Healthcare Performance Measurement

Performance appraisal has become an essential tool for healthcare managers due to the frequent and rapid changes in the healthcare sector. Sustainable performance management implies increasing organizations' efficiency and effectiveness while considering all vectors of sustainability. This study examines the impact of digital transformation, accounting information systems, and strategic human resource management improvements on organizational performance and sustainable development. The paper uses the balanced scorecard (BSC) for organizational performance assessment. The paper proposes a theoretical model that integrates the traditional and digital information systems and human resources engagement with the BSC dimensions for sustainable organizational development. The theoretical model is tested in an empirical study involving a questionnaire-based survey of 387 employees with management experience in the healthcare sector. Based on structural equation modeling, the research results showed that the efficiency and effectiveness of strategic human resources management and the accounting information system significantly positively affect the BSC dimensions. Furthermore, the use of BSC in measuring organizational performance has significant effects on sustainable development, with the internal process dimension being the most influential.

The Evolution of Balanced Scorecard in Healthcare: A Systematic Review of Its Design, Implementation, Use, and Review

During the last few years, the interest in performance measurement increased within the healthcare sector. Due to the COVID-19 pandemic, healthcare systems needed to boost performance measurement systems to become more resilient and improve their capability in monitoring key performance indicators. Since the 1990s, the Balanced Scorecard (BSC) model has been widely used among private and public organizations as it is the most adopted model to measure performance. The current paper aims at understanding the evolution of BSC in healthcare. The systematic literature review has been carried out by searching keywords according to PRISMA guidelines. By analyzing papers through one classification of BSC adoption phases, the results reveal that studies focused mainly on the BSC design process, rather than BSC implementation, use, or review. However, there is no agreement about the perspectives to be adopted in healthcare. Concerning BSC implementation and use, on one side especially leadership, culture and communication enable the BSC implementation. On the other side, monitoring and strategic decision-making are the most widespread objectives for using BSC. Concerning BSC review, however, the paper highlights a need for additional research. Finally, the paper provides further research opportunities concerning the phases suitable for implementing a BSC in healthcare.

How can universities engage lecturers in knowledge transfer? analyzing the influence of performance management systems

Purpose

There is an increasingly growing interest in treading beyond the traditional university goals of teaching and research to focus on their contribution to society through knowledge transfer (KT) performance activities. This paper aims to determine how performance management systems (PMSs) encourage lecturers to engage in the transfer of knowledge from higher education institutions (HEIs) to society.

Design/methodology/approach

This study is based on a sample of 3,812 Spanish university lecturers surveyed about different PMS tools – strategic plans, budgeting, meetings and reward systems – and different KT activities – research and development contracts, patents, extended patents, licenses, services and spin-offs – for the 2011–2016 period. A logit model was applied for the statistical analyzes.

Findings

As expected, enabling the use of these tools generally increases the probability of producing KT while only in some cases does coercive use reduce it. Moreover, combining enabling and coercive uses does not increase the likelihood of KT performance.

Practical implications

University policymakers and managers should reduce the gap between KT and research and teaching by, for example, examining the effects of their performance management practices on scholars’ perceptions and their subsequent behavior.

Originality/value

Despite previous literature states that coercive use decreases performance, the authors reveal that this is not the case for KT performance in HEIs. According to the findings, a specific record of KT, i.e. a coercive strategic plan tool, has a consistently positive effect on all four KT activities as follows: R&D contracts, patents, extended patents and licenses.

What is the performance in public hospitals? A longitudinal analysis of performance plans through topic modeling

BACKGROUND

Both the concept of performance and the role of hospitals in health systems evolved significantly in the last decades. Today, the performance in health could be defined as the ability to create 'population value,' and the hospitals' role is to support this aim by providing acute care and by integrating and coordinating their activity with other settings of care. This research aims to assess how and with what degree the management of public hospitals have embraced in practice the updated concept of performance and their new role.

RESULT

The paper analyses 181 performance plans of 48 Italian autonomous public hospitals over a nine-year period through the topic modeling algorithm called Latent Dirichlet Allocation (LDA). This is a method that allows for analysing large textual corpora that generates a representation of the latent topics discussed therein. The concept of performance in public hospitals was framed into 15 topics resulting from the analysis of the hospitals' performance plans. The prevalence of each topic was analysed through the period considered so as to understand the evolution of performance-related practices over the last decade.

CONCLUSION

In recent years, the concept of performance in hospitals evolved toward the adoption of an outcome-based and population-based perspective. Additional effort should be devoted toward improved collaboration and integration of care with other settings.

The Challenges of Hospitals' Planning & Control Systems: The Path toward Public Value Management

In the last decades, public management has been subjected to a shift from the New Public Management (NPM) paradigm to the Public Value Management (PVM) one. Thus, management practices such as Planning and Control (P&C) systems have been called to evolve accordingly. The health care sector has not escaped this process. This paper focuses on the evolution of hospitals’ P&C systems to support the paradigm shift from the NPM paradigm to the PVM one. In particular, the paper aims at exploring whether hospitals’ P&C systems in Italy evolved, or are evolving, consistently with PVM and what are the expected benefits related to such a paradigm switch. To address the research aim, the paper is based on a review of scientific and grey literature and the case study of the diabetic-foot pathway in an Italian Regional Healthcare System. The results of this study show that the current P&C systems in Italian hospitals are not yet designed to support the shift toward the PVM approach and are still mainly focused on financial aspects and intra-organizational dynamics. Combining traditional P&Cs with performance measures assessing the system’s outcomes may support hospitals in aligning their goals with the health system they are operating within and, therefore, P&C systems may represent an important driving force toward change. Such results provide suggestions for both practitioners and academics on how to adapt P&C systems to better support the implementation of current strategies of the public sector.

Text Mining and Quantitative Research of Medical Service Policy: Sichuan Province as an Example

Medical service policy plays a prominent role in the development of a “Healthy China.” This paper constructs a three-dimensional framework for text mining of medical service policy using the elements of policy instruments, policy strength, and types of medical service activity. Taking Sichuan Province as an example, 221 medical service policy documents, issued by the government and related departments, are selected as the research sample; the policy instruments, policy strength, and medical service activity types are analyzed using ROST and Nvivo 11.0 software. It is concluded that the government needs to optimize the structure of policy instruments, to appropriately reduce the use of environmental policy instruments in particular, while increasing the use of demand-based policy instruments. It is necessary to strengthen the interaction between the various sub-policy instruments, and to increase the use of financial services, fiscal taxes, overseas communications, and strategic measures. An increase in the implementation of government policy assists the acceleration of the policy landing, the further improvement of the supervision system, and the safeguard mechanism of the three medicine policy linkage, which can improve the sustainability of the medical service policy, and further resolve the difficulty and expense of seeing a doctor.

Monitoring Viability and Sustainability in Healthcare Organizations

The paper aims to advocate the incorporating of the sustainability perspective into the management control system of healthcare organizations. The study is based on two main premises: (1) the evolution of business models towards a wide perspective of the sustainability approach; (2) the evolution of control systems in healthcare organizations towards a control-based approach to monitor the effectiveness and efficiency of the service targeted primarily to cut costs and expenses. Our methodology is developed at theoretical and conceptual level starting from: (1) a literature review on the issue, highlighting main trends and gaps and (2) the adoption of the Viable Systems Approach (VSA) as a conceptual framework oriented to integrate a wide variety of stakeholder perspectives and interests into the business model. Our findings lead us to introduce the Systems Viability Monitoring Model for Sustainability as a potential reference framework to build healthcare management control systems in which the notion of ‘systems viability,’ as defined by VSA, becomes a bridging concept by means of which the sustainability perspective can be incorporated into the management control system of healthcare organizations.

Health Management Workforce for India in 2030

Introduction: Since its launch in the year 2005, National Rural Health Mission (NHM) has exhibited a felt need for health management training in India against the background of a shortfall of trained public health managers in the country. In India's context, health (hospital) management professionals are those, who are working in the health sector, belonging to medical and non-medical backgrounds and are trained in health (hospital) management/administration programs or other public health programs (for e.g., Master of Public Health) wherein health (hospital) management/administration is significant part of the curriculum. The presence of trained management professionals in the health sector has grown over the years. Objectives: To estimate the supply, need and requirement for health management professionals for India in the year 2030. Materials and methods: The supply data for health management professionals was calculated based on the output from various academic programs related to health management/administration and other public health programs. Need was calculated using "service target approach" and benchmark analysis with 2.97 health managers per 100,000 population (NACCHO 2011). Supply-need gap was estimated using normative need as base number for projections whereas for rest of the years (2018-2030) projections were done at a constant growth rate as per India's population projections. Results: The overall supply capacity of trained health management professionals was 3,463 for 2017. However, based upon a service target approach India requires 11,304 health management professionals in 2017. If India is to reach the normative standards of 2.97 health managers per 100,000 population, the country would need 39,774 health management professionals in 2017. This need would increase to approximately 44,936 health management professionals by the year 2030 to maintain the normative standard of 2.97 health managers per 100,000 population. Conclusions: The supply side will match the requirement of HMPs earliest by the year 2026 in a high seat occupancy scenario.Moreover, there is a need to improve the quality of the output in terms of an explicitly stated and standardized competency framework that is tailored to the Indian context.

Management Control Systems and Clinical Experience of Managers in Public Hospitals

Healthcare authorities are encouraging managers in hospitals to acquire clinical experience and knowledge in order to better carry out and coordinate healthcare service delivery. The main objective of this paper is to analyse how the clinical experience of hospital managers is related to public health institutions’ performance. It is proposed that the effect of the clinical experience on operative and financial organizational performance is indirect through the mediating variables of perceived utility of management information and horizontal management control system. This paper analyses how these variables impact hospital performance through the data from a survey sent to 364 hospital managers in Brazil. The results show that managers’ clinical experience is related to higher perceived utility of historical, financial, short-term, and internal information, but not with horizontal control adoption in hospitals. Furthermore, our results show that, in hospitals, perceived utility of forecasted, non-financial, long-term, and external managerial information positively affects hospitals’ financial performance, while adoption of horizontal control management positively affects operational performance. Through showing evidence that clinical background could explain the differences not only in hospital service management but also in information capabilities and management control processes, this study offer meaningful implications for healthcare authorities and hospital managers involved in the development and implementation of strategies in the health sector.

Employee reactions to the use of management control systems in hospitals: motivation vs. threat

OBJECTIVE

Management control systems (such as budgets or balanced scorecards) are formal procedures used by managers to promote employee behavior aligned with organisational objectives. Employees may react to these control systems by either becoming more motivated or perceiving them as a threat. The aim of this paper is to determine the extent to which hospital ownership (public or private), professional group (physician, nurse, pharmacist or administrative employee), type of contract (fixed or temporary), gender and tenure can condition employee reaction to management control systems.

METHODS

We conducted the study in the three largest hospitals in the State of Santa Catarina (Brazil), two public (federal and state-owned) and one private (non-profit organisation). Physicians, nurses, pharmacists and administrative employees received a questionnaire between October 2013 and January 2014 concerning their current perceptions. We obtained 100 valid responses and conducted an ANOVA variance analysis.

RESULTS

Our results show that the effect of management control systems on employees differs according to hospital ownership, professional group and type of contract. However, no significant evidence was found concerning gender or tenure.

CONCLUSIONS

The results obtained contribute to creating specific knowledge on the reactions of employees to the use of management control systems in hospitals. This information may be important in adapting management control systems to the characteristics of the hospital and its employees, which may in turn contribute to reducing dysfunctional worker behavior.