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“This is MY Health Care Program”: Enhancing Patient Adherence Through Psychological Ownership (WITHDRAWN)
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Author: Matthieu Mifsud, Audencia Business School
Author: Mathieu Molines, ESCE International Business School
Author: Anne-Sophie Cases, U. of Montpellier
Author: Gilles N’Goala, U. of Montpellier
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Psychological ownership has profound implications for the ways in which people behave, but this is rarely considered in the health care discourse related to chronic illness (Ye and Gawronski, 2016; Karnilowicz, 2011). Drawing on psychological ownership theory (Pierce and Jussila, 2011; Pierce, Kostova, and Dirks, 2003, 2001), this article proposes and tests a conceptual model that examines drivers of psychological ownership among patients as regards prescribed care programs and the impact of psychological ownership on patient adherence behavior. Data for this research study stems from a sample of 502 patients with diabetes in France. All hypothesized paths are statistically significant and in the predicted directions. Our study underlines the key role played by psychological ownership among patients and provides empirical evidence that a sense of ownership enhances patient adherence (in medical, physical and dietary terms). The findings are discussed with reference to existing theories and research on health care management and psychological ownership.
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Paper is No Longer Available Online: Please contact the author(s).
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A Mixed Methods Investigation of Factors Influencing Patient Perceptions of Integrated Care
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Author: Jonathan Clark, U. of Texas At San Antonio
Author: Sara Singer, Stanford U.
Author: Maike Vanessa Tietschert, Stanford U.
Author: Michaela Kerrissey, Harvard U.
Author: Mark Friedberg, RAND Corporation
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HCM Division Best Paper
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There is substantial variation in how well patient care is integrated across providers, even in similarly structured organizations. Yet, research about what provider organizations do, in practice, that enables or inhibits truly integrated care is limited. We applied mixed methods to identify mechanisms that organizations use to integrate care. First, we ranked physician organizations (POs) in a stratified sample based on their patients’ perceptions of how well the PO integrated their care. Then, in 115 semi-structured interviews, we asked professionals, patients, and family members in 10 more- and three less-integrated POs about the structures and processes involved in caring for patients with complex conditions. We then combined qualitative with quantitative methods to identify mechanism—and relationships among mechanisms—that are associated with performance on patient-perceived integrated care. From 6,104 interview excerpts, we identified 21 concepts related to the way PO’s integrate care. Quantitative analysis grouped these concepts into six themes. We found that POs’ ability to integrate care depended on the organization’s attentional perspective (i.e., people- versus systems-orientation) and on mechanisms for attentional engagement (i.e., interpersonal, functional, and stakeholder mechanisms). Perspective and engagement combined to direct provider and organizational efforts, leading to attentional selection (e.g., changes in attitudes/behaviors), which—for more integrated POs—focused on the patient. Results from this study suggest that POs’ ability to provide better integrated care depends on their ability to focus attention on the needs of patients by engaging providers through interpersonal and functional mechanisms that combine to overcome potential distractions. Implications for health care delivery organizations and policymakers are discussed.
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Paper is No Longer Available Online: Please contact the author(s).
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Sustainable Human Healthcare: The Centrality of Intrapreneurial Nurses
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Author: Angelique Ortiz-Hunt, Apex Center for Entrepreneurs
Author: Daniel Lerner, IE Business School
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HCM Division Best Theory to Practice
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Much is broken in the systems designed to deliver human healthcare. Without a fundamental reassessment, there is reason to doubt society’s capacity to guarantee the availability of basic healthcare for future generations. This empirical study develops and tests the premise that the entrepreneurial orientation of hospitals, evidenced through the development and implementation of intrapreneurship programs for nurses, is a decisive factor in attaining sustainable healthcare. We employ a matched pair sample of hospitals from diverse American cities to investigate the relationship between intrapreneurial nurses, patient outcomes and healthcare costs. Our findings reveal that nurses are the key stakeholder group in exerting material, positive effects on the sustainability of life-enhancing healthcare.
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Paper is No Longer Available Online: Please contact the author(s).
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Bringing Patient Values into Clinical Decision Making
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Author: Ila Bharatan, Warwick Business School
Author: Rachel Manning, Warwick Business School, U. of Warwick
Author: Jacky Swan, U. of Warwick
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Clinical decision-making has seen significant attempts to shift the process from being primarily clinician-led to the inclusion of patients. This is reflected in recent UK and US legislature on clinical decision-making. The emphasis on patient involvement highlights, the important, yet underexplored, role that patient values play in the decision making process. While literature has noted the importance of patient values to shared decision-making, in practice patient involvement in clinical decision remains far from straightforward. To understand the role that patient values play in clinical decision-making then; we need to understand how patient values are elicited and acted upon in the clinical decision-making process. Our study focuses on clinical decision-making in a vascular surgical practice in the UK. Here the clinical decision-making takes place primarily within multi-disciplinary team (MDT) meetings and patient clinics. Through observations and interviews, we show how patients voice is represented in the MDT and how this shapes the subsequent decision making. We also highlight how values are elicited in patient-clinician interaction and the different types of decision-making process that take place in patient-clinics. Through this, we contribute to the clinical decision making literature by highlighting how values are operationalised in the clinical decision-making process.
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Paper is No Longer Available Online: Please contact the author(s).
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