Department of Service Management and Logistics, Technology, Management and Economics, Chalmers University of Technology , Gothenburg, Sweden.
Sahlgrenska Academy, University of Gothenburg , Gothenburg, Sweden.
J Health Organ Manag. 2017 Jun 19;31(4):445-458. doi: 10.1108/JHOM-08-2016-0162.
Purpose The concept of value is becoming increasingly fashionable in healthcare and various improvement approaches (IAs) have been introduced with the aim of increasing value. The purpose of this paper is to construct a taxonomy that supports the management of parallel IAs in healthcare. Design/methodology/approach Based on previous research, this paper proposes a taxonomy that includes the dimensions of view on value and organizational focus; three contemporary IAs - lean, value-based healthcare, and patient-centered care - are related to the taxonomy. An illustrative qualitative case study in the context of psychiatric (psychosis) care is then presented that contains data from 23 interviews and focuses on the value concept, IAs, and the proposed taxonomy. Findings Respondents recognized the dimensions of the proposed taxonomy and indicated its usefulness as support for choosing and combining different IAs into a coherent management model, and for facilitating dialog about IAs. The findings also suggested that the view of value as "health outcomes" is widespread, but healthcare professionals are less likely than managers to also view value as a process. Originality/value The conceptual contribution of this paper is to delineate some important characteristics of IAs in relation to the emerging "value era". It also highlights the coexistence of different IAs in healthcare management practice. A taxonomy is proposed that can help managers choose, adapt, and combine IAs in local management models.
目的
在医疗保健领域,“价值”概念越来越流行,各种改进方法(IAs)也相继被引入,旨在提高价值。本文旨在构建一个分类法,以支持医疗保健中并行 IAs 的管理。
设计/方法/途径
基于先前的研究,本文提出了一个包含价值观和组织重点维度的分类法;将三种当代的 IAs - 精益、基于价值的医疗保健和以患者为中心的护理 - 与该分类法相关联。然后,本文呈现了一个在精神科(精神病)护理背景下的说明性定性案例研究,该研究包含了来自 23 次访谈的数据,重点关注价值概念、IAs 和所提出的分类法。
结果
受访者认识到所提出分类法的维度,并指出其作为支持选择和组合不同 IAs 为一个连贯的管理模型的有用性,以及促进关于 IAs 的对话。研究结果还表明,将价值视为“健康结果”的观点很普遍,但医疗保健专业人员比管理人员更不可能将价值视为一个过程。
原创性/价值
本文的概念贡献在于阐述了与新兴的“价值时代”相关的 IAs 的一些重要特征。它还强调了不同的 IAs 在医疗保健管理实践中的共存。本文提出了一个分类法,可以帮助管理人员在本地管理模型中选择、适应和组合 IAs。