Management, Organization, and Childbirth: Towards a New Model for the Birth Path

119 Pages·2022·6.621 MB·English

by  Gabriella Piscopo, Margherita Ruberto

Routledge studies in health management
MANAGEMENT,
ORGANIZATION, AND
CHILDBIRTH
TOWARDS A NEW MODEL FOR THE BIRTH PATH
Gabriella Piscopo and Margherita Ruberto
Management, Organization, and
Childbirth
Management, Organization, and Childbirth: Towards a New Model for the Birth
Path explores the complex topic of the birth path with a multidisciplinary
magnifying glass on the paradigms, languages, and tools critical to the
organization, management, and clinical science.
The work consists of five chapters. The first chapter provides a
multidimensional analysis of childbirth. The second chapter presents an
organizational analysis that moves in unison with different models of health.
The third chapter studies the birth path in organizational and clinical terms
by describing it in its core processes. The fourth chapter proposes a study
conducted in the Italian context, which identifies some useful determinants
for redesigning the birth path. The fifth chapter formulates a proposal for
redesigning the birth path based on a new health paradigm.
The proposed model offers useful insights for multiple categories of
readers. To students of medicine and higher education tracks in healthcare
management, it can offer opportunities to raise awareness not only
regarding multiprofessional practice but also regarding confrontation with
complementary disciplines. To practitioners and policy makers, it can
provide useful stimuli to promote rational and informed decisions around
the childbirth. To researchers studying the health context within different
disciplinary domains, the model can offer unexplored research spaces within
the new business complex system.
Gabriella Piscopo PhD in Public Management, is Associate Professor
of Organization Studies, Scientific Director of the “Observatory on
Organizational Behavior and Life Skills”, Deputy Director of the “Leadership
and Digital Transformation” Master at the University of Salerno, Italy. She is
Management Trainer and Scientific Coordinator of several research projects
on Healthcare, Judicial System and Complex Organizations.
Margherita Ruberto is PhD in Big Data Management at the University of
Salerno, Italy. She is an expert collaborator at AGENAS - National Agency
for Regional Health Services (PON Governance e Capacità Istituzionale
2014-2020)
Routledge studies in health management
Edited by Ewan Ferlie
The healthcare sector is now of major significance, economically, scientifically and
societally. In many countries, healthcare organizations are experiencing major
pressures to change and restructure, while cost containment efforts have been ac-
centuated by global economic crisis. Users are demanding higher service quality,
and healthcare professions are experiencing significant reorganization whilst oper-
ating under increased demands from an ageing population.
Critically analytic, politically informed, discursive and theoretically grounded,
rather than narrowly technical or positivistic, the series seeks to analyze current
healthcare organizations. Reflecting the intense focus of policy and academic in-
terest, it moves beyond the day to day debate to consider the broader implications
of international organizational and management research and different theoretical
framings.
Making Sense of Organizational Change and Innovation in Health Care
An Everyday Ethnography
Anne Reff Pedersen
Innovating Healthcare
The Role of Political, Managerial and Clinical Leadership
John Storey and Richard Holti
Co-production and Japanese Healthcare
Work Environment, Governance, Service Quality and Social Values
Victor A. Pestoff
Management, Organization, and Childbirth
Towards a New Model for the Birth Path
Gabriella Piscopo and Margherita Ruberto
Management,
Organization, and
Childbirth
Towards a New Model for the Birth
Path
Gabriella Piscopo and
Margherita Ruberto
First published 2023
by Routledge
605 Third Avenue, New York, NY 10158
and by Routledge
4 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2023 Gabriella Piscopo and Margherita Ruberto
The right of Gabriella Piscopo and Margherita Ruberto to be identified
as author[/s] of this work has been asserted in accordance with sections
77 and 78 of the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or reproduced
or utilised in any form or by any electronic, mechanical, or other means,
now known or hereafter invented, including photocopying and
recording, or in any information storage or retrieval system, without
permission in writing from the publishers.
Trademark notice: Product or corporate names may be trademarks or
registered trademarks, and are used only for identification and
explanation without intent to infringe.
ISBN: 978-1-032-36065-2 (hbk)
ISBN: 978-1-032-36066-9 (pbk)
ISBN: 978-1-003-33009-7 (ebk)
DOI: 10.4324/9781003330097
Typeset in Bembo
by MPS Limited, Dehradun
Contents
List of figures viii
List of tables ix
Foreword x
Acknowledgments xiii
Introduction 1
1 The multidisciplinary nature of childbirth 4
GABRIELLA PISCOPO AND MARGHERITA RUBERTO
1.1 Defining aspects and characteristics of the birth path 4
1.2 Social context: the social determinants and epidemiology of
birth path 5
1.3 Technological context: the tools to support the birth path 7
1.4 The multidisciplinary debate in the international scenario 10
References 11
2 The managerial and organizational perspective of
healthcare 18
GABRIELLA PISCOPO
2.1 Management profiles in healthcare: health paradigms and
institutional approaches 18
2.1.1 Complexity and variability of healthcare 18
2.1.2 Healthcare reforms and myths 19
2.2 The organizational perspective of healthcare 21
2.3 Process management in healthcare 25
2.4 The organizational approach of patient-centeredness 29
vi Contents
2.5 Healthcare process redesign and the challenge for the birth
path 32
References 34
3 The birth path as a process: criticalities and cesarean
section 41
GABRIELLA PISCOPO AND MARGHERITA RUBERTO
3.1 The stages of the birth path 41
3.2 Preconception care 41
3.3 Access to the birth path 43
3.4 Low-risk pregnancy pathway and medium-/high-risk
pregnancy pathway 44
3.5 Labor and delivery 47
3.6 Puerperium 49
3.7 Cesarean section and medicalization of pregnancy 51
3.7.1 Known medical risk factors 54
3.7.2 Social and demographic factors 54
3.7.3 Professional practice styles factors 55
3.7.4 Factors influencing maternal decision-making 55
3.7.5 Organizational factors 56
3.7.6 Economic factors 56
3.7.7 Cultural factors 57
References 58
4 Italian experience in the international context: em-
pirical evidence from two case studies 69
GABRIELLA PISCOPO AND MARGHERITA RUBERTO
4.1 Introduction to case studies 69
4.1.1 The Italian context 70
4.1.2 Theoretical foundation: the T.R.E.E. model 71
4.1.3 Data collection 73
4.1.4 Data analysis 75
4.2 Results 81
4.3 Discussion 82
References 84
5 Towards a new model for the birth path 87
GABRIELLA PISCOPO
5.1 Redesigning the birth path: toward a new model 87
Contents vii
5.2 Distributed health literacy and empowerment in the birth
path 90
5.3 ICT as a clinical and managerial support tool 92
5.4 Conclusions and implications for academic literature on
healthcare organizations 93
References 94
Index 100
Figures
2.1 The professional bureaucracy 23
2.2 The process approach within the healthcare context 28
3.1 The Value Systems in the birth path 42
3.2 Preconception phase 43
3.3 Access to the birth pathway phase 45
3.4 Low-risk pregnancy pathway and medium-/high-risk
pregnancy pathway 46
3.5 Labor and delivery phase 48
3.6 Puerperium phase 50
5.1 A Value Constellation for the birth path 88
Tables
3.1 Robson’s classification 53
4.1 Sample characteristics 73
4.2 Hospital 1’s DRG, weight, threshold, and ordinary
admissions 75
4.3 Hospital 2’s DRG, weight, threshold, and ordinary
admissions 75
4.4 Mode of delivery and mode of labor contingency table 76
4.5 Mode of delivery and mode of labor chi-square test 76
4.6 Mode of delivery and professional condition contingency
table 77
4.7 Mode of delivery and professional condition chi-square
test 77
4.8 Mode of delivery and maternal age contingency table 77
4.9 Mode of delivery and maternal age chi-square test 78
4.10 Mode of delivery and title of study contingency table 78
4.11 Mode of delivery and title of study chi-square test 78
4.12 Mode of delivery and previous conceptions contingency
table 79
4.13 Mode of delivery and previous conceptions chi-square
test 79
4.14 Group statistics: mode of delivery and number of
cesarean sections 79
4.15 Independent-samples test 80