The development of the concept of return-on-investment from large-scale quality improvement programmes in healthcare: an integrative systematic literature review

Thusini, S’thembile; Milenova, Maria; Nahabedian, Noushig; Grey, Barbara; Soukup, Tayana; Chua, Kia-Chong; Henderson, Claire

doi:10.1186/s12913-022-08832-3

Cited by 12 publications

(5 citation statements)

References 144 publications

(229 reference statements)

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“…2 Shows the revised QI-ROI Conceptual Framework (versions I-III). Versions I & II are re-published with permission by Thusini et al [ 15 , 16 ] respectively. Version III shows the new additions* implementation outcomes QI journey main process outcomes collateral outcomes …”

Section: Discussionmentioning

confidence: 99%

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How is return on investment from quality improvement programmes conceptualised by mental healthcare leaders and why: a qualitative study

Thusini,

Soukup,

Chua

et al. 2023

BMC Health Serv Res

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Background Return on Investment (ROI), whereby the ratio of costs to benefits is assessed, is encouraged in-order to justify the value of Quality Improvement (QI) programmes. We previously performed a literature review to develop a ROI conceptual framework for QI programmes. We concluded that, QI-ROI is conceptualised as any monetary and non-monetary benefit. In the current study, we explored if this finding is shared by mental healthcare leaders. We also investigated the stability of this conceptualisation against influencing factors and potential for disinvestment. Methods We performed qualitative interviews with leaders in an NHS mental health organisation. There were 16 participants: nine board members and seven senior leaders. The interviews were held online via Microsoft Teams and lasted an hour on average. We performed deductive-inductive analysis to seek data from our initial ROI framework and any new data. Results We found that in mental healthcare, QI-ROI is also conceptualised as any valued monetary and non-monetary benefits. There was a strong emphasis on benefits to external partners and a de-emphasis of benefit monetisation. This conceptualisation was influenced by the 1) perceived mandates to improve quality and manage scarce resources, 2) expectations from QI, 3) health and social care values, 4) ambiguity over expectations, and 5) uncertainty over outcomes. Uncertainty, ambiguity, and potential for disinvestment posed a threat to the stability of this conceptualisation but did not ultimately change it. Health and social care values supported maintaining the QI-ROI as any benefit, with a focus on patients and staff outcomes. Socio-political desires to improve quality were strong drivers for QI investment. Conclusion Mental healthcare leaders primarily conceptualise QI-ROI as any valued benefit. The inclusion of externalised outcomes which are hard to attribute may be challenging. However, mental healthcare services do collaborate with external partners. The de-emphases of benefit monetisation may also be controversial due to the need for financial accountability. Mental healthcare leaders recognise the importance of efficiency savings. However, they raised concerns over the legitimacy and utility of traditional ROI as a tool for assessing QI value. Further research is needed to bring more clarity on these aspects of the QI-ROI concept.

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Section: Discussionmentioning

confidence: 99%

“…We recently performed a systematic literature review where we studied ROI as a concept of returns or benefits from QI. This led to two studies; the first [ 15 ] describes our ROI concept analysis, development of the QI-ROI concept and its framework. We then further developed the framework by adding benefits that make up QI-ROI [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

How is return on investment from quality improvement programmes conceptualised by mental healthcare leaders and why: a qualitative study

Thusini,

Soukup,

Chua

et al. 2023

BMC Health Serv Res

Self Cite

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“…To prove that Return on Investment (ROI) affects underpricing during Initial Public Offerings (IPOs), this study aims to investigate the relationship between Return on Investment (ROI) and underpricing during IPOs. Return on Investment (ROI) is a ratio that measures the rate of return on an investment for a company (Thusini et al, 2022;and Fachrian & Hidayat, 2023). This research will test the hypothesis of whether companies with higher levels of Return on Investment (ROI) tend to experience lower or higher underpricing during Initial Public Offerings (IPOs).…”

Section: Literature Reviewmentioning

confidence: 99%

The Influence of Financial Indicators and Underwriter Reputation on Depreciated Stock Prices

Gunanto

2023

JAF

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This research aims to analyze the influence of financial indicators and underwriter reputation on the level of stock underpricing during Initial Public Offerings (IPOs) on the Indonesia Stock Exchange (IDX). The phenomenon of underpricing has gained attention in securities market research in various countries. This study adopts a conceptual analysis approach based on a review of existing literature. The theory of asymmetric information also serves as the foundation for explaining the underpricing phenomenon in IPOs. Factors include Return on Equity (RoE), Financial Leverage, Current Ratio, Earnings per Share (EPS), Size, Proceeds, Company Age, Auditor Reputation, Underwriter, and Industry Type. Therefore, this research aims to test the influence of financial indicators and underwriter reputation on the level of stock underpricing in IPOs on the IDX. Consequently, the findings from this research can be used as a basis for comparison with similar studies in other countries. This can help in understanding the differences and similarities in the phenomenon of stock valuation in various global capital markets. Keywords: IPO Underpricing, Financial indicators and Underwriter reputation

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“…Rural healthcare organizations may struggle to allocate sufficient resources to sustain these initiatives in the long term (Abelsen et al, 2020). Return on Investment (ROI) Uncertainty, Rural healthcare organizations may face uncertainty about the potential return on investment (ROI) associated with health informatics initiatives (Thusini et al, 2022). While these initiatives have the potential to improve efficiency, quality of care, and patient outcomes, quantifying the financial benefits can be challenging.…”

Section: Introductionmentioning

confidence: 99%

A review of the challenges and opportunities in implementing health informatics in rural healthcare settings

Samira Abdul,

Ehizogie Paul Adeghe,

Bisola Oluwafadekemi Adegoke

et al. 2024

imsrj

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This paper reviews the challenges and opportunities associated with implementing health informatics in rural healthcare settings. It examines the unique barriers rural communities face, such as infrastructure limitations, workforce shortages, and financial constraints, which can impede the adoption and utilization of health informatics solutions. However, it also explores the promising opportunities afforded by health informatics, including telemedicine, electronic health records (EHRs), and mobile health technologies, to overcome these challenges and improve healthcare access, quality, and efficiency in rural areas. By addressing these challenges and leveraging the opportunities presented by health informatics, stakeholders can work towards achieving equitable healthcare outcomes for rural populations. By addressing these challenges and leveraging the opportunities presented by health informatics, stakeholders can work towards achieving equitable healthcare outcomes for rural populations. Health informatics holds immense potential to revolutionize healthcare delivery, particularly in rural settings where access to quality care is often limited Health informatics holds immense potential to revolutionize healthcare delivery, particularly in rural settings where access to quality care is often limited. Health informatics holds immense potential to revolutionize healthcare delivery, particularly in rural settings where access to quality care is often limited. Telemedicine, for instance, enables remote consultations and diagnostic services, breaking down geographic barriers and providing rural patients with access to specialists and healthcare expertise they may not have locally. Electronic Health Records (EHRs) streamline administrative processes, improve care coordination, and enhance patient safety by ensuring that vital health information is readily accessible to healthcare providers regardless of location. Mobile health technologies, including smartp hone apps and wearable devices, empower rural residents to monitor their health, track chronic conditions, and engage in self-management activities from the comfort of their homes.By embracing these innovations and overcoming infrastructure challenges, stakeholders in rural healthcare can significantly improve healthcare access, quality, and efficiency. Additionally, leveraging health informatics can help address workforce shortages by enabling healthcare providers to deliver more effective and integrated care, even in remote areas. Ultimately, by harnessing the opportunities presented by health informatics while addressing the unique challenges of rural healthcare, stakeholders can work towards achieving equitable healthcare outcomes for rural populations. Keywords: Health Informatics, Rural Healthcare, Electronic Health Records (EHRS), Mobile Health, Challenges.

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The development of the concept of return-on-investment from large-scale quality improvement programmes in healthcare: an integrative systematic literature review

Cited by 12 publications

References 144 publications

How is return on investment from quality improvement programmes conceptualised by mental healthcare leaders and why: a qualitative study

How is return on investment from quality improvement programmes conceptualised by mental healthcare leaders and why: a qualitative study

The Influence of Financial Indicators and Underwriter Reputation on Depreciated Stock Prices

A review of the challenges and opportunities in implementing health informatics in rural healthcare settings

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