Roman A. Lewandowski

• PhD (dr hab. inż. prof. UWM)
• Managing Director at Voivodeship Rehabilitation Hospital for Children in Ameryka, Poland

The purpose of this study was to examine the differences in intrinsic vs. extrinsic motivation among medical students, doctors, and nurses in two countries-Ukraine and Poland. As a secondary aim, gender differences were considered as well. During 2019, until the beginning of 2020, before the COVID-19 pandemic started, healthcare professionals from...

In response to increasing costs of treatment, governments have shifted formal responsibility for hospitals from physicians to managers. This has forced the latter to introduce control over clinical activities. Some hospitals monitor medical processes not only at the level of wards but delve into the clinical activities of individual doctors. The ob...

For years, problems related to health-care efficiency have been at the top of the priorities of many hospitals systems and governments. The growing cost of health care, and particularly hospitals, is a significant factor in the increasing pressure for improvement of hospitals’ efficiency while maintaining a high quality of services. Hospitals are r...

Health information can influence patient trust and is vital to the healthcare system of a country. This study comparatively assesses trust levels within Poland’s healthcare system from two perspectives: non-healthcare workers (i.e. lay people) and healthcare workers. Four trust indicators, i.e. the payer, visiting or consulting with a physician, th...

Background: In May 2021, there was an incident regarding giving patients AstraZeneca vaccines stored improperly. They were stored at room temperature (21 degrees centigrade) for 18 h, 12 h longer than the producer recommends. Aim of the study: The paper aims to contribute to the body of knowledge concerning the efficacy and safety of the ChAdOx1...

Due to the limited recognition of management control in hospitals and the relevance of the subjective views of the study's participants, an exploratory, sequential mixed-methods research procedure was employed, using first qualitative and then quantitative methods. This resulted in triangulation between methods, which increased the reliability of t...

that reflect organizational expectation and delineate performance ; (2) a measurement comprising of the metrics used to operationalize performance; (3) a review referring to the evaluation and feedback of performance information; (4) a performance-related reward system, and (5) a "refresh-ing" phase (Franco-Santos and Otley 2018). "Refreshing" of P...

Książka kompleksowo prezentuje zagadnienia związane z kontrolą menedżerską w szpitalach publicznych. Wdrożenie wskazanych w opracowaniu rozwiązań pomoże szpitalom poprawić uzyskiwane wyniki, w tym jakość i efektywność dostarczanych usług medycznych, a co za tym idzie – zapewnić lepszą opiekę zdrowotną pacjentom. Publikacja jest rezultatem wieloletn...

Person-centred care (PCC) is an increasing international priority and a shift in health systems orientation and development. Innovative models are required across Europe to prototype healthcare based on health promotion and PCC to improve healthcare quality and costs containment. Regardless of the type of intervention, investments will be required,...

This chapter is divided into three sections. The first section introduces the concept and models of shared decision-making as a framework of person-centered care. The second section focuses on multicriteria decision-making techniques in healthcare settings and literature review about multicriteria decision making analysis methods used in healthcare...

We explore the alternative explanation for barriers and facilitators for implementation of PCC evolving from human resources through the lenses of institutional theory. We have deepened the explanation by adding the perspective of different institutional logics, which shows that the physician's resistance or nurses’ support may originate from the d...

Background This study empirically evaluates the influence of medical information on patient trust at the physician level, the medical profession, hospitals, and with the payer. Restoring patient trust in a medical setting in Poland appears to be significantly affected due to the COVID-19 pandemic. Patient trust improves results from medical treatme...

Background Increasing healthcare costs need to be contained in order to maintain equality of access to care for all EU citizens. A cross‐disciplinary consortium of experts was supported by the EU FP7 research programme, to produce a roadmap on cost containment, while maintaining or improving the quality of healthcare. The roadmap comprises two driv...

Background: Person-Centered Care (PCC) is a promising approach towards improved quality of care and cost containment within health systems. It has been evaluated in Sweden and England. This feasibility study examines initial PCC implementation in a rehabilitation hospital for children in Poland. Methods: The WE-CARE Roadmap of enablers was used...

Background: This study empirically evaluates the influence of information on trust at the physician level, the medical profession, hospitals, and with the payer. Restoring trust in a medical setting appears to be significantly affected due to the coronavirus pandemic. Trust improves results from medical treatment, raises perception of healthcare pe...

The dataset is covering a three-stage experiment in an unchanging group of respondents. The experiment was conducted from 18 September 2015 to 26 January 2016 in Polish two medium-sized enterprises, on the occasion of a multi-staged training program concerning quality systems. The training was conducted in permanent groupings and on all organizatio...

Forthcoming industry 4.0 era will bring new challenges for management control (MC) research and practice. Extant studies demonstrate that organizations characterized by a high level of technological complexity and innovation capability need control forms based more on social than on cybernetic mechanisms. Although many frameworks concerning MC rese...

Most public hospitals are complex organizations subject to external political and social influence, populated by medical professionals who identify more with their professional group than with the organization in which they work (Kuhlmann et al., 2013). Doctors institutional logics (IL) are different from hospitals’ managers (Lewandowski and Sułkow...

Introduction: This article examines different motivators for medical staff in countries with a high gap in healthcare efficiency by comparing them in two healthcare systems— Polish (ie efficient) and Ukrainian (ie inefficient). Method: This survey-based study applies a six-stage conceptual framework to two Polish and two Ukrainian hospitals as well...

Person-centred care is known as a novel approach which contributes to wellbeing, prevention, care and support of patients. There is little evidence about practising PCC in stroke rehabilitation. In this paper, we develop a novel framework for creation of person-centred services for stroke rehabilitation which supports service configuration adapted...

Wprowadzenie i cel pracy. W ostatnim czasie w krajach za¬chodnich duże uznanie zyskało nowe podejście do leczenia i opieki nad pacjentem, nazywane opieką zorientowaną na osobę (OZO). W Polsce podejście to nie jest szerzej znane, pomimo iż wykazano jego pozytywne rezultaty zarówno w zakresie poprawy jakości leczenia, rehabilitacji i opieki, jak i og...

The COST CARES project aims to support healthcare cost containment and improve healthcare quality across Europe by developing the research and development necessary for person-centred care (PCC) and health promotion. This paper presents an overview evaluation strategy for testing ‘Exploratory Health Laboratories’ to deliver these aims. Our strategy...

As a result of a multinational and multi-industrial scientific project, a framework supporting implementation of Person-Centred Care (PCC) and Health Promotions (HP) has been developed. The framework has been called "WE-CARE Roadmap" and consists from five enablers: technology, quality measures, infrastructure, incentive systems and contracting str...

Likert scale items are used for surveys exploring attitudes by collecting responses to particular questions or groups of related statements. The common practice is asking respondents to express their level of agreement by applying the seven or five-point scale from ‘strongly disagree’ to ‘strongly agree’. Although the Likert scale methodology serve...

We rarely think that our health is often not so much in our hands, but it is in the hands of the medical staff that treats and cares us. And we do not even realize that these people in medical coats can be in a bad mood, negatively disposed towards their work, and dissatisfied with their careers and lives. Moreover, it is a psychological state of t...

BACKGROUND: Connected Health (CH) as a new paradigm looks after the individual and community health in a connected and holistic manner by leveraging a variety of technologies and has a promising potential for the incorporation of telehealth and integrated care services, covering the whole spectrum of health-related services addressing healthy subje...

BACKGROUND Connected Health (CH) as a new paradigm looks after the individual and community health in a connected and holistic manner by leveraging a variety of technologies and has a promising potential for the incorporation of telehealth and integrated care services, covering the whole spectrum of health-related services addressing healthy subjec...

The main purpose of our research is to propose original algorithm to evaluate the dynamic behavior of processes from the survey data collected with the help of periodically repeated surveys based on Likert scale questions. This approach supposes the usage of AHP (Analytic Hierarchy Process) for assessment the factors influencing the process behavio...

The research aim of this chapter is to understand how different institutional logics affect the day-to-day activities of healthcare providers and whether the cohabitation of professional logics with business-like logics increases medical providers’ effectiveness and gives chance to constrain healthcare costs. This research is based on longitudinal...

Rozwój technologii medycznych sprawił, że znacznie poprawiła się skuteczność leczenia, ale zarazem nastąpił relatywnie duży wzrost jego kosztów. Doprowadziło to do sytuacji, w której opieka zdrowotna przestała być problemem medycznym należą-cym wyłącznie do lekarzy, a w dużej mierze stała się zagadnieniem ekonomicznym, leżącym w gestii menedżerów,...

Objective : The aim of the research was to construct a theoretical model of competences of managers employed in health care institutions in the Warmińsko-Mazurskie Voivodeship. Methodology : The theoretical list of competences was based on the literature of the subject and the results developed during the workshop session with postgraduate students...

The main force hybridising healthcare sector is the increasingly dominant policy agenda aiming at the containment of public spending for health. Governments, in order to maintain near-universal medical coverage for all their citizens, begun to implement New Public Management principles and other instruments the purpose of which is to increase the e...

Control is the fundamental function of management, but companies due to the increasingly turbulent environment and public organizations because of purposes ambiguity have to seek more flexible forms of control aimed at self-control. Thus, both sanctions and rewards associated with the control system must be less associated with factors that are ext...

The European Network for the Joint Evaluation of Connected Health Technologies (ENJECT) is a COST action that brings together an international consortium, including business and revenue modellers, clinicians, technologists, engineers, economists, ethnographers, and health researchers to help society to answer one question – how to connect therapies...

Balanced Scorecard (BSC) is recommended as a universal tool of strategic management of information age organizations. Studies of organizations using BSC carried out until now have not determined causes of failures in the use of BSC. The aim of this study is to test the hypothesis, "BSC is fully adapted to be used as a management tool for informatio...

Zarządzanie w praktyce. Certyfikaty Wojewódzkiego Szpitala Rehabilitacyjnego dla Dzieci w Ameryce. W: M. Kautsch (Red.), Zarządzanie w opiece zdrowotnej: Nowe wyzwania (Drugie, s. 496-499). Warszawa: Wolters Kluwer Polska. 6. Zarządzanie w praktyce. Certyfikaty Wojewódzkiego Szpitala Rehabilitacyjnego dla Dzieci w Ameryce 1 Wojewódzki Szpital Rehab...

Zarządzanie w praktyce. Zrównoważona Karta Wyników jako narzędzie zarządcze. W: M. Kautsch (Red.), Zarządzanie w opiece zdrowotnej: Nowe wyzwania (Drugie, s. 389-391). Warszawa: Wolters Kluwer Polska. 4. Zarządzanie w praktyce. Zrównoważona Karta Wyników jako narzędzie zarządcze Wojewódzki Szpital Rehabilitacyjny dla Dzieci w Ameryce zajmuje się le...

Introduction: The prevalence of lateral curvatures of the spine ranges from 0.3% to 15.3% in the general population. The aim of the study was to develop and compare three different screening tests for idiopathic scoliosis (IS) with respect to their effectiveness and costs. Material and methods: The Delphi method was used to assess the efficacy o...

(Oral presentation in Yokohama) Poland, like other European post-communistic countries inherited the inefficient health care system. The first major reform was implemented in 1999, ten years after the fall of communism. The reform changed hospital financing from fixed budget to payment for performance and granted private medical organizations acces...

Abstract: The financial situation of hospitals in Poland is diverse, despite the fact that they operate in similar environ-ment. Significant impact on the situation in hospitals can be attributed to medical professionals who are shaping costs and revenues by taking daily autonomous decisions concerning patient treatment. What gives professionals th...

Background. Some Polish hospitals are in a good financial position but others are not, even though they are of a similar size according to their budgets, the number and structure of specialists and type of society they serve. Furthermore, it is difficult to find the factors re-sponsible for their different financial standing. To investigate deeper...

Hospital governance increasingly combines management and professional self-governance. This article maps the new emergent modes of control in a comparative perspective and aims to better understand the relationship between medicine and management as hybrid and context-dependent. Theoretically, we critically review approaches into the managerialism-...

The medical profession has always a high degree of autonomy. However, the rapid growth of health care costs that has started in the second half of the last century, has forced governments to tighten the control over medical practice and introduce managers into medical organizations, and also to induce competitive forces in health care systems. Howe...

Across countries, management has brought tighter controls into all areas of clinical practice, responding mainly to financial shortages coupled with increasing public demand for quality and safety of care. Management is not simply expanding and creating new roles for non-clinical managers, but doctors, too, are charged with managerial responsibilit...

Streszczenie Ochrona zdrowia boryka się z niewystarczającą jakością usług, spowodowaną głównie niską siłą rynkową pacjentów. Wydaje się, że skutecznym sposobem wzmocnienia roli pacjentów jest poszerzenie zastosowania technologii teleinformatycznych umożliwiających pacjentom, jak również zatrudnionym przez nich zewnętrznym konsultantom, nieograniczo...

The article presents comparison of three most frequently used quality management systems in the Polish health care organizations, the family of ISO 9000 norms, EFQM Excellence Model and Monitoring Centre Quality Accreditation in Health Care for their impact on improving the quality of medical services, divided into six dimensions of quality: qualit...

IntroductionMethods of financing health care services constantly undergo changes. These changes involve both the allocated financial resources and average prices received for person-day of treating patients in hospital departments of various specialties. Thus, a constant monitoring of financing levels and service pricing in particular types of heal...

"During recent years, management has brought tighter controls into all areas of clinical practice, responding mainly to financial shortages coupled with increasing public demand for quality and safety of care. Management is not simply expanding and creating new roles for non-clinical managers, but doctors, too, are charged with managerial responsib...

Russia demonstrates one of the lowest levels of health indicators among the developed countries. In terms of life expectancy at birth, Russia is in the 160th place out of 224 countries ranked in the CIA Fact Book, behind India. This situation is particularly appalling among men. Data from 2006 show that life expectancy at birth for men is 17 years...

Streszczenie Artykuł dotyczy zagadnień związanych z zaufaniem w ochronie zdrowia. Przedstawiono w nim korzyści, które odnosi zarówno pacjent, jak i świadczeniodawca przy wysokim poziomie zaufania pacjenta do świadczeniodawcy, m.in.: lepsze wyniki leczenia, przestrzeganie reżimu zaleconej terapii, większą motywację do poszukiwania pomocy i korzystan...

Sektor ochrony zdrowia należy do tych gałęzi gospodarki, w których jakość jest czynnikiem krytycznym, każdy błąd może spowodować tragedię konkretnej osoby. Dlatego też tak istotnym jest, aby zakłady opieki zdrowotnej traktowały proces podnoszenia jakości priorytetowo. W ostatnich latach coraz więcej placówek medycznych podejmuje działania na rzecz...

Trust is one of the fundamental elements of social and economic life. The fewer oppor-tunities to control and supervise the trustee has the truster, and the more important for the truster the entrusted object is the more crucial it becomes to them. Hence, the above leads to the need for research in the field of understanding the reasons of trust an...

The aim of the study is to identify the main research objects of trust in health care and initially assess the level of trust in these objects and their susceptibility to change. The research hypothesis, that the observed low level of trust in health care, especially in public payer (National Health Fund) and the health care system originate not fr...

Książka zawiera następujące artykuły: Rola informatyzacji w procesie świadczenia usługi szpitalnej – redukcja ryzyka decyzyjnego – Bobrer Benedykt; Przedsięwzięcia zmniejszające zużycie energii elektrycznej na oświetlenie w obiektach użyteczności publicznej – Dołęga Waldemar; Konfiguracja swobody decyzyjnej wyzwaniem menedżerskim w ochronie zdrow...

Idiopathic scoliosis (IS), despite multidirectional therapy, involves a significant impairment of the quality of life of the patients. It is caused by pain syndromes frequently accompanying IS, the etiology of which has not been entirely discovered. The present research on environmental factors predisposing to pain syndromes in girls with IS involv...

Książka zawiera następujące artykuły: Rola informatyzacji w procesie świadczenia usługi szpitalnej – redukcja ryzyka decyzyjnego – Bober Benedykt; Przedsięwzięcia zmniejszające zużycie energii elektrycznej na oświetlenie w obiektach użyteczności publicznej – Dołęga Waldemar; Konfiguracja swobody decyzyjnej wyzwaniem menedżerskim w ochronie zdrowi...

Od lat 90-tych zarządzanie procesowe jest postrzegane jako obiecujące podejście do usprawniania firm i zwiększania ich orientacji na klienta. Podejście to przenika również do placówek ochrony zdrowia. Przed przystąpieniem do planowania zmian struktury organizacyjnej, związanej z wprowadzeniem zarządzania procesowego, w pierwszym rzędzie należy zide...

W pracy przedstawiono czynniki upośledzające efektywność szpitali w Polsce oraz zidentyfikowano uwarunkowania determinujące strukturę organizacyjną tych jednostek. Zaproponowano model struktury macierzowej szpitala, który umożliwia wprowadzenie zarządzania procesowego obejmującego również leczenie pacjentów cierpiących na schorzenia wielonarządowe....

Streszczenie Artykuł przedstawia możliwość zastosowania filozofii x engineeringu w ochronie zdrowia. Szersze wykorzystanie technologii teleinformatycznych pozwala na udostępnienie wewnętrznych procesów placówek medycznych partnerom, tj. innym placówkom medycznym, dostawcom, a przede wszystkim pacjentom, co poprawia przepływ pacjentów pomiędzy poszc...

Streszczenie: W pracy przedstawiono przesłanki do zastosowania Zarządzania Przez Wartości (ZPW) w organizacjach, ze szczególnym uwzględnieniem organizacji ochrony zdrowia. Zidentyfikowano mechanizmy powodujące większe zobligowanie pracowników do postępowania zgodnie z przejętymi w organizacji wartościami i uzyskiwanie przez nich dzięki temu większe...

Artykuł opisuje dysproporcje w finansowaniu rehabilitacji w warunkach stacjonarnych i lecznictwa szpitalnego

Książka zawiera następujące artykuły: Finansowanie systemu ochrony zdrowia w wybranych krajach „starej” i „nowej” Unii Europejskiej - Kazimierz Ryć, Zofia Skrzypczak; System finansowania ochrony zdrowia w Polsce - Adam Szczęch; Determinanty rozwoju niepublicznego ubezpieczenia zdrowotnego w Polsce - Jacek Ruszkowski; Wydatki bezpośrednie gospodar...

The article presents the possibility of the Balanced Scorecard and EFQM Excellence Model simultaneous application in public healthcare organizations. There has been characterized and compared the two concepts of management in terms of usage in healthcare entities. The management area has been identified in which those concepts proof more effective....

Jednym z najistotniejszych problemów współczesnej ochrony zdrowia na świecie oprócz rosnących kosztów jest utrzymanie wysokiej i powtarzalnej jakości usług. Każde rozwinięte państwo stara się rozwiązać ten problem, z jednej strony zmuszając świadczeniodawców, m. in., poprzez służby sanitarne, do zachowania minimalnych standardów jakościowych, z dru...

Health care units quality certificates market in Poland Certifying quality has a long tradition, it started in the 50s of the 20th century in the military supplying systems and then spread to most areas of economy worldwide. In health care quality of services it is the issue of enormous importance. Therefore the quality assuring and control systems...

There are two methods certifying the quality in Polish healthcare: certification according to the ISO 9001:2001 norm and CMJ accreditation. Number of healthcare units, which have these documents has recently substantially grown. The evidence shows that it does not bear real quality increase of services provided by the units. The paper reveals the n...

Najczęściej wykorzystywanymi modelami zewnętrznej oceny systemu zarządzania jakością w organizacjach ochrony zdrowia w Polsce są: Program Akredytacji Szpitali Centrum Monitorowania Jakości w Ochronie Zdrowia; rodzina norm ISO 9000, ISO 14000, ISO 22000 i polska norma PN-N 18001 oraz samoocena zgodna z modelem doskonałości EFQM w ramach Regionalnej...

W artykule autorzy przedstawiają wyniki badań dotyczące uwarunkowań wprowadzania strategii zarządzania jakością w ochronie zdrowia. W Wojewódzkim Szpitalu Rehabilitacyjnym dla Dzieci w Ameryce przeprowadzono ankietę wśród wszystkich grup zawodowych i poziomów zarządzania, zakładając, że każdy pracownik przyczynia się do wdrożenia i przestrzegania z...

Introduction: The era of computer testing, measurement and decision-making systems began in the second half of the 20th century. Medical application of such systems manifests itself in digital devices for the observation of the patient's condition, X-ray and laboratory diagnostics. In this article the authors concentrate on the decision-making syst...

Streszczenie. Niniejsza publikacja opisuje zastosowanie modelu Servqual do oceny jakości usług medycznych świadczonych w szpitalu. Model Servqual opiera się na pomiarze różnicy pomiędzy oczekiwaniami pacjentów dotyczącymi jakości usługi a postrzeganą jakością wykonanej usługi. W badaniu zastosowano standardowy arkusz Servqual z 22 stwierdzeniami i...

W ostatnich latach w naszym kraju coraz więcej placówek medycznych inicjuje programy projakościowe. W ramach tych programów podejmowane są różnorodne działania: wdrażana jest koncepcja zarządzania przez jakość, szpitale biorą udział w regionalnej i polskiej nagrodzie jakości poddając się samoocenie zgodnie z modelem doskonałości Europejskiej Fundac...

Warunki funkcjonowania publicznych organizacji ochrony zdrowia coraz bardziej upodabniają się do warunków, w jakich funkcjonują firmy komercyjne. Szczególnie duże i skomplikowane podmioty, takie jak szpitale muszą poszukiwać nowoczesnych narzędzi zarządzania, aby optymalizować koszty i zwiększać jakość świadczonych usług. Instrumentem, który spełni...