Exploring integrated supply chain performance in healthcare: a service provider perspective

Enhancing Interoperability for a Sustainable, Patient-Centric Health Care Value Chain: Systematic Review for Taxonomy Development

BACKGROUND

Creating a sustainable, patient-centered health care system necessitates integrated supply chains supported by information technologies. However, achieving interoperability among various devices and systems remains a significant hurdle. Our research highlights the need for systematic reviews that address health care interoperability as a holistic knowledge domain. Notably, we observed a lack of studies that outline its structure or develop a comprehensive, high-order facet-based taxonomy from the perspective of supply or value chains. This study aims to address that gap.

OBJECTIVE

The primary aim of this study is to elucidate the knowledge structure within the extensive domain of health care interoperability, with an emphasis on trending topics, critical hot spots, and the categorization of significant issues. Furthermore, we aim to model the higher-order elements of a taxonomy for health care interoperability within the context of the health care value chain framework.

METHODS

We used both quantitative and qualitative methodologies. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework guided our selection process. We examined 6 databases-Scopus, Web of Science, IEEE Xplore, Embase, Cochrane, and PubMed-focusing on journal articles and gray literature published from 2011 onward. Articles were screened using predefined eligibility criteria. Quantitative bibliometric techniques-including cluster, factor, and network analyses-were applied to explore the structure of the knowledge. A subset of articles was selected for qualitative synthesis using an iterative coding process to develop a higher-order facet-based taxonomy.

RESULTS

We identified 370 articles for quantitative analysis. The bibliometric analysis revealed 2 major clusters. Key terms in the first cluster included interoperability, electronic health record, and eHealth-with betweenness centralities of 70.971, 59.460, and 12.000, respectively, and closeness centralities of 0.047, 0.043, and 0.034, respectively. In the second cluster, the most relevant terms were IoT, blockchain, and health care-with betweenness centralities of 6.765, 2.581, and 1.283, respectively, and closeness centralities of 0.034, 0.030, and 0.030, respectively. Factor analysis explained 59.46% of the variance in a 2-factor model, with the first dimension accounting for 36.78% and the second dimension for 22.68%. The qualitative review of 79 articles yielded a taxonomy with 4 higher-order facets: object (what is shared), source (what mechanism is used), ambit (space covered), and content (technology primarily involved). Each facet extended to a third level of classification.

CONCLUSIONS

The comprehensive domain of health care interoperability, viewed through the lens of a sustainable value chain, encompasses studies that highlight various facets or attributes. These studies underscore the relevance of eHealth within this knowledge domain and reflect a strong focus on 2 key health information technologies: electronic health records and the Internet of Things.

Confirmation of a measurement model for hospital supply chain resilience

Background

The hospital supply chain has revealed increasing vulnerabilities and disruptions in the wake of the COVID-19 pandemic, threatening the healthcare services and patient safety. The resilience of hospital supply chains has emerged as a paramount concern within the healthcare system. However, there is a lack of systematic research to develop an instrument tailored to the healthcare industry that is both valid and reliable for measuring hospital supply chain resilience. Therefore, this study aims to construct and validate a comprehensive scale for assessing hospital supply chain resilience, based on dynamic capability theory.

Methods

This study followed rigorous scale development steps, starting with a literature review and 15 semi-structured interviews to generate initial items. These items were then refined through expert panel feedback and three rounds of Delphi studies. Using data from 387 hospitals in Province S, mainland China, the scale underwent rigorous testing and validation using structural equation modeling. To ensure the most effective model, five alternative models were examined to determine the most suitable parsimonious model.

Results

The study produced a 26-item scale that captures five dimensions of resilience in line with dynamic capability theory: anticipation, adaptation, response, recovery, and learning, all showing satisfactory consistency, reliability and validity.

Conclusion

The multi-dimensional scale offers hospital managers a valuable tool to identify areas needing attention and improvement, benchmark resilience against their counterparts, and ultimately strengthen their supply chains against unexpected risks.

Structural modeling of the relationship between teachers' power sources and educational gain with the mediating role of the psychosocial climate of Kabul University

The aim of this study was to investigate the structural relationship between teachers' power sources, educational gain, and the mediating role of the psychosocial climate in high school classrooms. Participants included 362 students (223 females and 125 males) who were randomly selected through cluster sampling. All participants voluntarily completed questionnaires about teacher power sources, psychosocial classroom climate, and educational gain. Structural equation modeling and Smart PLS 3.3.2 software were used to analyze the data. The findings indicated a significant positive relationship between teachers' power sources and educational gain. There was also a positive and significant relationship between teachers' power sources and the psychosocial classroom climate. Conversely, a negative relationship was found between the psychosocial classroom climate and educational gain. Moreover, the results showed a positive and significant relationship between teachers' power sources and educational gain, with the psychosocial classroom climate mediating this relationship. These findings emphasize the importance of teachers' optimal use of various power sources to create a favorable psychosocial classroom climate, which can significantly contribute to students' educational gain.

Compliance of public health facilities with essential medicines and health supplies redistribution guidelines in Mbale district, Eastern Uganda: a mixed-methods study

INTRODUCTION

Redistribution of essential medicines and health supplies (EMHS) is a mechanism to address supply chain uncertainty by moving excess stock of health commodities from health facilities that are overstocked to health facilities with shortages, where it is most needed. It prevents the wastage of scarce resources and improves efficiency within a health supply chain system. Many public health facilities in Uganda experience stock-outs, overstocking, and expiry of essential medicines. This study assessed the compliance of public health facilities with the Uganda Ministry of Health redistribution strategy for EMHS in Mbale district, Eastern Uganda.

METHODS

A mixed-methods study was conducted among 55 respondents at public health facility level and five key informants at the district level. Audio-recorded data were transcribed and coded to develop themes. Thematic analysis was performed using ATLAS.ti Version 8.5. Quantitative data were analysed using IBM SPSS Version 24.0.

RESULTS

About a third (33%) of the surveyed health facilities complied with EMHS redistribution guidelines. Respondents agreed that EMHS redistribution had helped reduce health commodity expiries and stock-outs in health facilities. Respondents who did not know about the timely release of funds for redistribution were 68% less likely to comply, and those who said the guidelines were never shared were 88% less likely to comply with the guidelines.

CONCLUSIONS

Compliance with the EMHS redistribution guidelines was low and associated with failure to share the guidelines with staff and inadequate awareness about release funds for EMHS redistribution. The district local government should allocate more funds to the EMHS redistribution.

Hospital Organizational Structure and Information Processing: An Entropy Perspective

Organizational structure enables organizations to achieve their goals. The chosen organizational structure determines, to a large extent, the flow of information streams and the manner and extent to which roles, power, and responsibilities are delegated and coordinated to achieve the organization's goals. In this study, we applied information theory with entropy as the central concept to assess the effectiveness and costs of an organizational structure and its coordination processes. Entropy was used to measure the amount of uncertainty associated with probabilistic events. In the context of organizational design, entropy values can be assigned to specific organizational structures to gain insights into the factors that lead to delays in decision-making. We used Shannon's entropy theory to quantify Galbraith's organizational structure and coordination process as applied to the perinatology care system of Radboud University Medical Centre in the Netherlands. Our entropy analysis provided insights into how departments should be partitioned and which coordination mechanisms should be used to achieve organizational goals, such as minimizing delays in decision-making. Particularly, two types of entropy appear to be important: positional entropy and task allocation entropy. These are different dependent variables on the organizational design scenarios. Our analysis shows that entropy is one method to determine optimal organizational structures and coordination processes. Entropy can be used as a concrete way of assessing the effectiveness of organizational design given the level of uncertainty of the environment and the required speed of decision-making.

Analysis of critical success factors for blockchain technology implementation in healthcare sector

Purpose

Recently, blockchain technology (BT) has resolved healthcare data management challenges. It helps healthcare providers automate medical records and mining to aid in data sharing and making more accurate diagnoses. This paper attempts to identify the critical success factors (CSFs) for successfully implementing BT in healthcare.

Design/methodology/approach

The paper is methodologically structured in four phases. The first phase leads to identifying success factors by reviewing the extant literature. In the second phase, expert opinions were solicited to authenticate the critical success factors required to implement BT in the healthcare sector. Decision Making Trial and Evaluation Laboratory (DEMATEL) method was employed to find the cause-and-effect relationship among the third phase’s critical success factors. In phase 4, the authors resort to validating the final results and findings.

Findings

Based on the analysis, 21 CSFs were identified and grouped under six dimensions. After applying the DEMATEL technique, nine factors belong to the causal group, and the remaining 12 factors fall under the effect group. The top three influencing factors of blockchain technology implementation in the healthcare ecosystem are data transparency, track and traceability and government support, whereas; implementation cost was the least influential.

Originality/value

This study provides a roadmap and may facilitate healthcare professionals to overcome contemporary challenges with the help of BT.

Patient-centered communication: an extension of the HCAHPS survey

Purpose

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) has been recognized as a “gold standard” set of “practical standardized measures” for assessing hospital service quality. Beginning with the HCAHPS, the purpose of this paper is to extend efforts to assess patient-centered communication (PCC) and the quality of healthcare and presents a scale for measuring patient perceptions and expectations of service quality in an emerging economy context.

Design/methodology/approach

A self-administered survey of patients in private hospitals (N = 171) was conducted to test the proposed framework. Exploratory and confirmatory factor analyses were used to establish the measurement model. Multiple regression analysis was used to explain the scale's predictive ability. ANOVA was used to analyze service quality gaps and rank patients' priorities.

Findings

Five components of PCC are identified. Among these, nurse affective communication has a significant positive effect on patient satisfaction. The gap analysis shows that patients have high expectations for doctors' affective communication, while they perceive a low level of service performance in the realm of nurse affective communication. The study highlights a new means of measuring “reliability” in healthcare. Important findings on patients' priorities are evaluated and discussed.

Practical implications

Healthcare organizations and practitioners can improve patient-centered care by stressing the dimensions of PCC, including clinicians' affective and instrumental communication.

Originality/value

The study expands the understanding of HCAHPS instruments in an emerging economy context and opens avenues for more widespread use of the measures. The research contributes to the literature on patient-centered care and healthcare service quality by proposing a scale for managing specific practices and interactions in healthcare.