1,720,984 research outputs found
Workforce management design and reorganization strategies as response to staff shortages in nursing homes services
No full textThe global aging population and the rise in chronic disabilities are fueling demand for long-term care (LTC), with Nursing homes (NHs) playing a crucial role in meeting the elderly’s care needs. Staff shortages, however, threaten the effectiveness of LTC services. To enhance LTC sustainability and care quality, effective workforce planning and new staff management strategies are necessary. Despite the nursing staff shortage, there is still limited academic research on key managerial strategies to maximize LTC cost-effectiveness. Consequently, this chapter addresses the chal-
lenge of examining solutions to overcome the staffing crisis by providing effective workforce management and reorganization strategies. A PRISMA-based systematic literature review on the nursing homes management field was conducted, extracting contributions focused on LTC service delivery and its interconnection with staff shortage. The sample was investigated through conceptual analysis, which returned four macro areas of solution to overpass staff paucity. Consistent with the value-based healthcare paradigm and using a grounded approach, these findings were then integrated into a proposal for a comprehensive model addressing staff shortages, which consist of: (i) LTC demand estimation and staff allocation, (ii) new supply strate-
gies, (iii) staff and process reorganization. Accordingly, the model implementation, as tailored to a healthcare district’s specific needs, could yield significant outcomes, including cost reduction, job satisfaction and retention, and enhanced quality in LTC services
Mobile-Health based physical activities co-production policies towards cardiovascular diseases prevention: findings from a mixed-method systematic review
Full text linkBackground: Cardiovascular disease (CVD) is the first cause of death globally, with huge costs worldwide. Most cases of CVD could be prevented by addressing behavioural risk factors. Among these factors, there is physical and amateur sports activity (PASA), which has a linear negative correlation with the risk of CVD. Nevertheless, attempts to encourage PASA, as exercise prescription programmes, achieved little impact at the community-wide level. A new frontier to promote PASA is represented by mobile health tools, such as exergaming, mobile device apps, health wearables, GPS/GIS and virtual reality. Nevertheless, there has not yet been any evident turnabout in patient active involvement towards CVD prevention, and inactivity rates are even increasing. This study aims at framing the state of the art of the literature about the use of m-health in supporting PASA, as a user-centric innovation strategy, to promote co-production health policies aiming at CVD prevention. Methods: A mixed-method systematic literature review was conducted in the fields of health and healthcare management to highlight the intersections between PASA promotion and m-health tools in fostering co-produced services focused on CVD prevention. The literature has been extracted by the PRISMA logic application. The resulting sample has been first statistically described by a bibliometric approach and then further investigated with a conceptual analysis of the most relevant contributions, which have been qualitatively analysed. Results: We identified 2,295 studies, on which we ran the bibliometric analysis. After narrowing the research around the co-production field, we found 10 papers relevant for the concept analysis of contents. The interest about the theme has increased in the last two decades, with a high prevalence of contributions from higher income countries and those with higher CVD incidence. The field of research is highly multi-disciplinary; most of documents belong to the medical field, with only a few interconnections with the technology and health policy spheres. Although the involvement of patients is recognized as fundamental for CVD prevention through PASA, co-design schemes are still lacking at the public management level. Conclusions: While the link between the subjects of motor activity, medicine and technology is clear, the involvement of citizens in the service delivery process is still underinvestigated, especially the issue concerning how “value co-creation” could effectively be applied by public agencies. In synthesis, the analysis of the role of co-production as a system coordination method, which is so important in designing and implementing preventive care, is still lacking
La Telemedicina tra innovazione e sostenibilità: modello operativo generale e tassonomia delle risorse coinvolte
Full text linkIl progressivo innalzamento dell’età media delle popolazioni nei Paesi Occidentale ha contribuito all’incremento esponenziale del tasso d’incidenza delle mattie croniche e all’aumento di poli-patologie e nuove sindromi, con importanti ripercussioni sulle esigenze socio-sanitarie diffuse.
Tale circostanza sta fortemente mettendo a rischio la sostenibilità economico-finanziaria dei Sistemi Sanitari Nazionali, costringendoli a fronteggiare una nuova sfida legata all’erogazione di servizi sanitari qualitativamente adeguati e a costi contenuti.
In tale contesto, le tecnologie digitali possono rappresentare un elemento estremamente rilevante per vincere tale sfida. Tra queste, in particolare, la Telemedicina si configura come un’innovazione tecnologica clinicamente efficacie, capace di incrementare l’equità d’accesso ai servizi assistenziali, con simultanea riduzione delle risorse necessarie alla loro erogazione. Un’innovazione, dunque, pienamente coerente con le logiche del Value-Based Healthcare.
Nonostante le sue elevate potenzialità, la diffusione della Telemedicina stenta ancora a diffondersi nei processi correnti delle organizzazioni sanitarie; ciò sembra essere prevalentemente imputabile all’esigenze di cambiamento delle strutture produttive ed organizzative, nonché di conoscenze, tecnologie e processi operativi, che le aziende devono affrontare per introdurre tale innovazione.
Tuttavia, la conoscenza e l’analisi delle le risorse richieste per l’ammodernamento dei processi assistenziali, sembra essere un prerequisito vincolante a tale percorso di cambiamento.
A partire da ciò, il presente lavoro ha l’obiettivo di delineare le caratteristiche generali di un modello di erogazione di assistenza sanitaria in Telemedicina, e di classificare, per tipologia, le risorse necessarie alla sua implementazione.
Tale disamina può contribuire, dunque, alla definizione di una prima base di conoscenza utile alle decisioni d’investimento in sanità digitale, con il fine di agevolare la valutazione di convenienza economica e di recuperabilità di tale tipologia d’investimento
WHAT DOES PATIENT NEED? How Technology may influence patients’ Co-Production inclination in diabetes management
No full textToward digital transformation in healthcare: a framework for remote monitoring adoption
No full textPurpose Digital transformation (DT) is a priority for the healthcare sector. In many countries, it is still considered in the early stages with an underestimation of its benefits and potentiality. Especially in Italy, little is known about the impact of digitalization - particularly of the Internet of Things (IoT) - on the healthcare sector, for example, in terms of clinician's jobs and patient's experience. Drawing from such premises, the paper aims to focus on an overlooked healthcare area related to the chronic heart diseases field and its relationship with DT. The authors aim at exploring and framing the main variables of remote Monitoring (RM) adoption as a specific archetype of healthcare digitalization, both on patients and medical staff level, by shedding some lights on its overall implementation. Design/methodology/approach The authors empirically inquiry the RM adoption within the context of the Cardiology Department of the Casilino General Hospital of Rome. To answer our research question, the authors reconstruct the salient information by using induction-type reasoning, direct observation and interviewees with 12 key informants, as well as secondary sources analysis related to the hospital (internal documentation, presentations and technical reports). Findings According to a socio-technical framework, the authors build a model composed of five main variables related to medical staff and patients. The authors classify such variables into an input-process-output (I-P-O) model. RM adoption driver represents the input; cultural digital divide, structure flexibility and reaction to change serve the process and finally, RM outcome stands for the output. All these factors, interacting together, contribute to understanding the RM adoption process for chronic disease management. Research limitations/implications The authors' research presents two main limitations. The first one is related to using a qualitative method, which is less reliable in terms of replication and the interpretive role of researchers. The second limitation, connected to the first one, is related to the study's scale level, which focuses on a mono-centric consistent level of analysis. Practical implications The paper offers a clear understanding of the RM attributes and a comprehensive view for improving the overall quality management of chronic diseases by suggesting that clinicians carefully evaluate both hard and soft variables when undertaking RM adoption decisions. Social implications RM technologies could impact on society both in ordinary situations, by preventing patient mobility issues and transport costs, and in extraordinary times (such as a pandemic), where telemedicine contributes to supporting hospitals in swapping in-person visits with remote controls, in order to minimize the risk of coronavirus disease (COVID-19) contagion or the spread of the virus. Originality/value The study enriches the knowledge and understanding of RM adoption within the healthcare sector. From a theoretical perspective, the authors contribute to the healthcare DT adoption debate by focusing on the main variables contributing to the DT process by considering both medical staff and patient's role. From a managerial perspective, the authors highlight the main issues for RM of chronic disease management to enable the transition toward its adoption. Such issues range from the need for awareness of the medical staff about RM advantages to the need for adapting the organizational structure and the training and education process of the patients
Patients' Key Indications: relevant issues for a balanced health technology evaluation from users' standpoint
No full textHow Information Availability Changes Healthcare Chronicity Management: Findings from a Pilot Case Study
No full textChronic diseases are a crucial matter for worldwide National Health Systems; they represent one of the first causes of disability, mortality and morbidity, due to their persistency and tendency to develop some degree of disability (WHO, 2013).
To ensure the economic and social sustainability of such diseases, new healthcare business models development should be considered. Accordingly, Chronic Diseases Management shows how patients are enabled to actively take part of their healthcare by taking advantage of Internet of Things (IoT) (Batalden et al., 2018).
This is particularly highlighted in cardiac chronicity: patients enhance their health status, by increasing the participation level (Osborne et al., 2016) on their care pathway, through telemedicine.
Accordingly, the main purpose of this work is to explain how is possible to improve real time medical information exchange between patient and hospital, by using technological infrastructures. Just in time information allows the clinical staff to improve the chronicity management. This means: increasing quality of life for patients, optimisation of hospital workload, cost saving.
Design/methodology/approach – It was adopted a pilot case study method (Yin, 2014), classified as “Extreme Case Sampling” (Patton, 2002). Study concerns with the observation of remote management of a group of heart failure (HF) patients that, at moment of discharge, are equipped with: i) electrocardiograph; ii) weight scale; iii) pulse- oximeter; iv) sphygmomanometer. All those medical devices are connected with a mobile transmitter. Thus, according with his/her own clinical protocol, each patient provides both the self-measurement and dispatch of his/her own clinical data. These data are sent on a website platform, where, on a daily basis, cardiology staff check them.
Originality/value – The availability of these biomedical parameters allows medical staff to predict patient’s health status evolution. Before a patient’s health condition worsens, a predictive model, based on patients’ co- production and IoT, allows the medical staff to provide a TRIAGE aimed at promptly manage those troubled patients. Preliminary findings show that: i) patients were managed exclusive by telephone contact ii) no HF relapse, iii) no ER transit; iv) none hospitalization. Also a cost saving was observed.
Practical implications – Empirical experience demonstrates that possibility to share clinical information might change the traditional paradigm (Cahn, 2000) of service providing. As complexity increases, information requirements increase; thus, managerial approaches to healthcare change. Patient’s participation and IoT technologies become critical drivers in chronicity management sustainability: operative inputs able to enhance also Social Value of services provided
Enhancing the Sustainable Goal of Access to Healthcare: Findings from a Literature Review on Telemedicine Employment in Rural Areas
Full text linkFighting health inequalities is a challenge addressed by the United Nations Strategic Development Goals (UN-SDGs). Particularly, people living in rural areas suffer from a lack of health infrastructure, which would jeopardize their inclusion in universal coverage for specialist care. Delivering valuable healthcare in underserved areas can be achieved through the employment of new technical innovations, such as telemedicine, which improves service delivery processes. Accordingly, this paper discusses how telemedicine strategies have enhanced the sustainability of right of “access to healthcare” in rural areas. Once we derived the sustainability pillars for healthcare from the UN-SDGs 3 and 10 according to the WHO innovation assessment metrics, a PRISMA-based literature review was conducted using the Scopus database. English, peer-reviewed articles/reviews from 1973 to 2019 were considered. The enquiry covers two analyses: (i) quantitative-bibliometric on 2267 papers; and (ii) qualitative-narrative on the 30 most significant papers. Interest about the topic has increased in the last decade following digitalization diffusion. The most productive and collaborative countries are those with huge dimensions and under financial restrictions. From a sustainability-oriented standpoint, telemedicine enhances both emergency and diagnostic healthcare in rural areas by decreasing the cost of services, expanding coverage of specialist cares, and increasing the quality of the outcomes. For health policies, telemedicine can be considered a suitable solution for providing cost-effective and sustainable healthcare
Cost accounting del follow-up annuo per il controllo remoto dei defibrillatori impiantabili
No full textThe use of Digital Tools to Promote Physical Activity as Preventive Factor for Cardiovascular Diseases. Barrier and Opportunities fpr Health Public Systems
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