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Background: The use of Artificial Intelligence (AI) tools in hospital management holds potential for enhancing decision-making processes. This study investigates the current state of decision-making in hospital management, explores the potential benefits of AI integration, and examines hospital managers' perceptions of AI as a decision-support tool. Methods: A descriptive and exploratory study was conducted using a qualitative approach. Data were collected through semi-structured interviews with 15 hospital managers from various departments and institutions. The interviews were transcribed, anonymized, and analyzed using thematic coding to identify key themes and patterns in the responses. Results: Hospital managers highlighted the current inefficiencies in decision-making processes, often characterized by poor communication, isolated decision-making, and limited data access. The use of traditional tools like spreadsheet applications and business intelligence systems remains prevalent, but there is a clear need for more advanced, integrated solutions. Managers expressed both optimism and skepticism about AI, acknowledging its potential to improve efficiency and decision-making while raising concerns about data privacy, ethical issues, and the loss of human empathy. The study identified key challenges, including the variability in technical skills, data fragmentation, and resistance to change. Managers emphasized the importance of robust data infrastructure and adequate training to ensure successful AI integration. Conclusions: The study reveals a complex landscape where the potential benefits of AI in hospital management are balanced with significant challenges and concerns. Effective integration of AI requires addressing technical, ethical, and cultural issues, with a focus on maintaining human elements in decision-making. AI is seen as a powerful tool to support, not replace, human judgment in hospital management, promising improvements in efficiency, data accessibility, and analytical capacity. Preparing healthcare institutions with the necessary infrastructure and providing specialized training for managers are crucial for maximizing the benefits of AI while mitigating associated risks. [ABSTRACT FROM AUTHOR]

Background: Medical undergraduate students are often unaware of the managerial aspects of operating a healthcare facility. This leads to confusion and a sense of being lost when they assume administrative roles, highlighting the need for hospital management and leadership training. This prompted us to evaluate the needs of medical undergraduates concerning these crucial aspects. Methods: An exploratory study was conducted on 240 medical undergraduate students to assess the medical undergraduates' need to learn about hospital management and leadership training, their views about the importance and their self-perceived knowledge of the various elements of hospital management and leadership training. A meticulously validated questionnaire, comprising three essential parts, based on the Likert scale was effectively employed in the study. Part A asked students to evaluate the importance of 15 selected elements of hospital management and leadership training, ranging from not important to very important, in their role as a doctor. Part B required the students to assess their self-perceived knowledge levels on a scale from no knowledge to very adequate for the same 15 elements. Part C inquired about the students' opinions on including these topics in their curriculum and, if so, the appropriate timing. Results: Nearly 75% of the students felt that time management, stress management, and patient safety issues were very important for their role as doctor. Closely following these were communication/ public relation skills, hospital information system & record keeping, quality improvement/assurance, law, ethics & code of conduct. Only 25% of the students reported their self-perceived knowledge as very adequate for almost all the elements. For inclusion in the curriculum, the majority wanted to learn about these elements and throughout the course was the preferred timing. Conclusion: The students felt that hospital management and leadership training were pivotal for their roles as doctors. They expressed a lack of sufficient knowledge in these areas and the need for these important aspects to be included in their curriculum as a longitudinal course. [ABSTRACT FROM AUTHOR]

Background: Healthcare organizations are under pressure to improve services because of an aging population and increasing healthcare demands. Lean healthcare management focuses on improving service quality and efficiency under the condition of limited resources, but it may overlook patients' emotional needs and experiences, especially in developing countries. This study advocates integrating medical humanities with lean healthcare to develop a patient-centered service model. Methods: The study employs literature review to discuss the critical role of medical humanities in lean healthcare frameworks, both theoretical and practical. Additionally, it conducts a qualitative study through semi-structured interviews to explore strategies for developing a humanistic lean healthcare model. The study conducts semi - structured interviews with eight management staff members and doctors in a tertiary hospital in China that actively adopts this approach. Results: Eight managers and doctors (five female and three male) were interviewed between January and March 2024 at their chosen locations. Firstly, the study identifies key benefits of integrating medical humanities into lean healthcare, which are as follows: (1) Enhancing the personalization and comprehensiveness of services. (2) Building trust in doctor-patient relationships. (3) Boosting the satisfaction of healthcare teams. Secondly, it highlights strategies for a humanistic approach, namely: (1) Conducting comprehensive patient assessments and providing personalized treatments. (2) Enhancing doctor - patient communication for emotional resonance. (3) Optimizing the medical environment for humanized services. (4) Developing humanistic qualities among healthcare professionals. (5) Using information technology effectively. Additionally, the study also addresses potential issues regarding lean healthcare's focus on profitability and proposes preventive measures: (1) Implementing a scientific evaluation and incentive mechanism. (2) Enhancing transparency and oversight in healthcare. (3) Cultivating a patient - centric medical culture. Conclusions: This research proposes a patient-centered lean healthcare model integrating medical humanities, providing a novel framework for improving service quality and efficiency while ensuring compassionate care. This management framework can support the reform of public hospitals in China and also serve as a reference for other countries. [ABSTRACT FROM AUTHOR]

Background: Organizational health literacy (OHL) describes conditions and measures in healthcare institutions to enable patients to make good health-related decisions. By providing easy access to and appropriate communication of understandable information to use and navigate the facility, healthcare organizations can contribute to strengthening patients' health literacy and self-management. The extent of OHL implementation in German hospitals remains largely unknown. This study aims to fill this gap in our knowledge by investigating OHL-related activities reported by hospital managers. Methods: Between November and December 2022, we conducted a national online survey among medical, nursing and administrative hospital managers with hospitals that operate more than 50 beds. The data were collected via the health literate health care organization ten item questionnaire (HLHO-10) and supplemented by sociodemographic questions and an open-ended question. We applied variance and correlation analyses to investigate the data. Results: Of 3,301 invited hospital managers, 371 participated in the survey (response rate 11%). The overall mean score for HLHO-10 was 4.6 (SD = 1.1) on a 7-point Likert scale, indicating a moderate level of OHL implementation. Hospital managers stated that hospitals concentrate on helping patients find their way around and communicating the costs of treatment transparently and clearly; conversely, that active patient participation in the design and evaluation of health information is rare in care settings, and that health information is seldom provided to patients through a range of media. For the practical implementation of the OHL, most hospital managers mentioned activities regarding communication standards, such as providing information materials. Conclusions: Given their unique position as hubs of human interaction, hospitals provide an ideal opportunity to promote the adoption of OHL. By actively involving patients, hospitals can better tailor their approaches to meet patient needs and preferences. Compared to studies from oncology centres in Germany and 20 Italian hospitals, the average HLHO-10 score of this study is lower. While some aspects of OHL are already embedded in inpatient care, it is imperative that OHL is thoroughly embedded in the hospitals' organizational culture and plays a fundamental role in the daily operations of the institution. This could be done, for instance, by more explicitly addressing the topic of health literacy in staff communication training. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to identify the perception of opportunities and risks by hospital managers with regard to the implementation of autonomous care robots in practice. Methods: The empirical study is based on a qualitative research approach and uses the grounded theory methodology. Using purposive sampling, 11 experts for in-depth interviews were selected to gain the necessary data. The interviews were recorded and transcribed. The transcripts were coded and analyzed using MAXQDA software. Results: The care provided by autonomous robots is generally positively perceived by hospital management; it is expected that it will inevitably be put into practice, even if it brings considerable risks. These are, however, outweighed by the advantages resulting from, for example, value-neutral care, uninterrupted availability, increased independence for patients, maintaining the system despite a shortage of nursing staff, etc. A large-scale reorganization of hospital funding will be necessary, as well as communication with patients to help them become confident in robotic care. Conclusion: There was widespread agreement across the interviews that it will no longer be possible to provide nursing care without robots in the future. Nursing staff should start preparing, i.e., get training so that they perceive robots as their helpers and not as threats or competitors, and this joint care of humans and robots should be included in nursing practice during high school studies. [ABSTRACT FROM AUTHOR]

Objective: There is a demand to make hospital management information beyond basic key performance indicators (KPIs) accessible for clinicians. Methods: We developed an interactive application (IAPP) in R Shiny to visualize such information. We provided the IAPP source code online. As a use case, we recorded basic KPIs (numbers of patients (NPs), reimbursed valuation ratios (RVRs), mean length of stay (LOS)), main diagnoses (MDGNs), main procedures (MPRCs), and catchment area (CA) by district from April 2022 to March 2024 at the index department in central Germany, where a neurotrauma and spinal surgery service was resumed on 1 April 2022. Case mix indexes (CMIs) were calculated. We retrieved information about online-reported patient satisfaction (ORPS) from an online physician rating platform between January 2022 and March 2024. Information on longitudes and latitudes of the index department and neighbouring hospitals was collected. We calculated car travelling isochrones (CTIs) of the hospitals as a proxy variable for accessibility. Chi-square and Fisher's exact served as statistical tests. Results: During the observation period, the monthly NPs increased from 26 to 43, the RVR showed a 3.96-fold increase, the CMI showed a 2.41-fold increase, and the LOS reached a steady state in the 2nd year after service resumption. CA (p = 0.03), MDGNs, and MPRCs diversified. ORPS trended towards better overall evaluation after service resumption (p = 0.09). CTI mapping identified a unique market position of the index department. Conclusions: The IAPP makes extended hospital management data accessible to clinicians, can inform other stakeholders in healthcare, and can be tailored to local conditions. [ABSTRACT FROM AUTHOR]

Copyright of Environmental & Social Management Journal / Revista de Gestão Social e Ambiental is the property of Environmental & Social Management Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Badra Al Aufa,1 Wahyu Sulistiadi,2 Nia Murniati,1 Dian Kusuma,3 Mochamad Iqbal Nurmansyah4 1Vocational Education Program, Universitas Indonesia, Depok, Indonesia; 2Faculty of Public Health, Universitas Indonesia, Depok, Indonesia; 3School of Health & Medical Sciences, City St George’s University of London, London, UK; 4Faculty of Health Sciences, Universitas Islam Negeri Syarif Hidayatullah, Jakarta, IndonesiaCorrespondence: Badra Al Aufa, Vocational Education Program, Universitas Indonesia, Depok, 16425, Indonesia, Email badra@vokasi.ui.ac.idAbstract: Several studies show that the implementation of health promoting hospital (HPH) standard in Indonesian hospital has not reached optimal levels. Therefore, this study aimed to explore the implementation of health promoting hospital standard at a private hospital in Depok, Indonesia. This descriptive study was conducted at the end of 2023. A purposive sampling with a total of 20 health workers who are responsible for health promotion programs from various backgrounds, including nurses, physiotherapists, laboratory technicians, midwives, and pharmacists, was involved in this study. The instrument containing 35 questions was adopted from the Health Promoting Hospital Guidelines issued by the Indonesian Ministry of Health in 2018, which included four standards, namely: 1) policy and management, 2) assessment, 3) intervention, as well as 4) monitoring and evaluation. Meanwhile, descriptive analysis was performed using SPSS version 29.0. The results showed that assessment standards had the highest average score of 73.72, followed by the intervention of 72.71 out of a maximum of 100. The lowest score was reported in the monitoring and evaluation standard, with an average of 67.82. The components within each standard had an average score of less than 3 out of a maximum of 4. Organizational changes through short-term interventions, including leadership involvement and training the staff, were necessary to enhance the implementation effectiveness of health promoting hospital standards.Keywords: health promoting hospital, service quality, hospital management, developing countries

Abstract Background Medical undergraduate students are often unaware of the managerial aspects of operating a healthcare facility. This leads to confusion and a sense of being lost when they assume administrative roles, highlighting the need for hospital management and leadership training. This prompted us to evaluate the needs of medical undergraduates concerning these crucial aspects. Methods An exploratory study was conducted on 240 medical undergraduate students to assess the medical undergraduates’ need to learn about hospital management and leadership training, their views about the importance and their self-perceived knowledge of the various elements of hospital management and leadership training. A meticulously validated questionnaire, comprising three essential parts, based on the Likert scale was effectively employed in the study. Part A asked students to evaluate the importance of 15 selected elements of hospital management and leadership training, ranging from not important to very important, in their role as a doctor. Part B required the students to assess their self-perceived knowledge levels on a scale from no knowledge to very adequate for the same 15 elements. Part C inquired about the students’ opinions on including these topics in their curriculum and, if so, the appropriate timing. Results Nearly 75% of the students felt that time management, stress management, and patient safety issues were very important for their role as doctor. Closely following these were communication/ public relation skills, hospital information system & record keeping, quality improvement/assurance, law, ethics & code of conduct. Only 25% of the students reported their self-perceived knowledge as very adequate for almost all the elements. For inclusion in the curriculum, the majority wanted to learn about these elements and throughout the course was the preferred timing. Conclusion The students felt that hospital management and leadership training were pivotal for their roles as doctors. They expressed a lack of sufficient knowledge in these areas and the need for these important aspects to be included in their curriculum as a longitudinal course.

Abstract Background The use of Artificial Intelligence (AI) tools in hospital management holds potential for enhancing decision-making processes. This study investigates the current state of decision-making in hospital management, explores the potential benefits of AI integration, and examines hospital managers’ perceptions of AI as a decision-support tool. Methods A descriptive and exploratory study was conducted using a qualitative approach. Data were collected through semi-structured interviews with 15 hospital managers from various departments and institutions. The interviews were transcribed, anonymized, and analyzed using thematic coding to identify key themes and patterns in the responses. Results Hospital managers highlighted the current inefficiencies in decision-making processes, often characterized by poor communication, isolated decision-making, and limited data access. The use of traditional tools like spreadsheet applications and business intelligence systems remains prevalent, but there is a clear need for more advanced, integrated solutions. Managers expressed both optimism and skepticism about AI, acknowledging its potential to improve efficiency and decision-making while raising concerns about data privacy, ethical issues, and the loss of human empathy. The study identified key challenges, including the variability in technical skills, data fragmentation, and resistance to change. Managers emphasized the importance of robust data infrastructure and adequate training to ensure successful AI integration. Conclusions The study reveals a complex landscape where the potential benefits of AI in hospital management are balanced with significant challenges and concerns. Effective integration of AI requires addressing technical, ethical, and cultural issues, with a focus on maintaining human elements in decision-making. AI is seen as a powerful tool to support, not replace, human judgment in hospital management, promising improvements in efficiency, data accessibility, and analytical capacity. Preparing healthcare institutions with the necessary infrastructure and providing specialized training for managers are crucial for maximizing the benefits of AI while mitigating associated risks.

Abstract Background Organizational health literacy (OHL) describes conditions and measures in healthcare institutions to enable patients to make good health-related decisions. By providing easy access to and appropriate communication of understandable information to use and navigate the facility, healthcare organizations can contribute to strengthening patients’ health literacy and self-management. The extent of OHL implementation in German hospitals remains largely unknown. This study aims to fill this gap in our knowledge by investigating OHL-related activities reported by hospital managers. Methods Between November and December 2022, we conducted a national online survey among medical, nursing and administrative hospital managers with hospitals that operate more than 50 beds. The data were collected via the health literate health care organization ten item questionnaire (HLHO-10) and supplemented by sociodemographic questions and an open-ended question. We applied variance and correlation analyses to investigate the data. Results Of 3,301 invited hospital managers, 371 participated in the survey (response rate 11%). The overall mean score for HLHO-10 was 4.6 (SD = 1.1) on a 7-point Likert scale, indicating a moderate level of OHL implementation. Hospital managers stated that hospitals concentrate on helping patients find their way around and communicating the costs of treatment transparently and clearly; conversely, that active patient participation in the design and evaluation of health information is rare in care settings, and that health information is seldom provided to patients through a range of media. For the practical implementation of the OHL, most hospital managers mentioned activities regarding communication standards, such as providing information materials. Conclusions Given their unique position as hubs of human interaction, hospitals provide an ideal opportunity to promote the adoption of OHL. By actively involving patients, hospitals can better tailor their approaches to meet patient needs and preferences. Compared to studies from oncology centres in Germany and 20 Italian hospitals, the average HLHO-10 score of this study is lower. While some aspects of OHL are already embedded in inpatient care, it is imperative that OHL is thoroughly embedded in the hospitals’ organizational culture and plays a fundamental role in the daily operations of the institution. This could be done, for instance, by more explicitly addressing the topic of health literacy in staff communication training.

Abstract Background Healthcare organizations are under pressure to improve services because of an aging population and increasing healthcare demands. Lean healthcare management focuses on improving service quality and efficiency under the condition of limited resources, but it may overlook patients’ emotional needs and experiences, especially in developing countries. This study advocates integrating medical humanities with lean healthcare to develop a patient-centered service model. Methods The study employs literature review to discuss the critical role of medical humanities in lean healthcare frameworks, both theoretical and practical. Additionally, it conducts a qualitative study through semi-structured interviews to explore strategies for developing a humanistic lean healthcare model. The study conducts semi - structured interviews with eight management staff members and doctors in a tertiary hospital in China that actively adopts this approach. Results Eight managers and doctors (five female and three male) were interviewed between January and March 2024 at their chosen locations. Firstly, the study identifies key benefits of integrating medical humanities into lean healthcare, which are as follows: (1) Enhancing the personalization and comprehensiveness of services. (2) Building trust in doctor-patient relationships. (3) Boosting the satisfaction of healthcare teams. Secondly, it highlights strategies for a humanistic approach, namely: (1) Conducting comprehensive patient assessments and providing personalized treatments. (2) Enhancing doctor - patient communication for emotional resonance. (3) Optimizing the medical environment for humanized services. (4) Developing humanistic qualities among healthcare professionals. (5) Using information technology effectively. Additionally, the study also addresses potential issues regarding lean healthcare’s focus on profitability and proposes preventive measures: (1) Implementing a scientific evaluation and incentive mechanism. (2) Enhancing transparency and oversight in healthcare. (3) Cultivating a patient - centric medical culture. Conclusions This research proposes a patient-centered lean healthcare model integrating medical humanities, providing a novel framework for improving service quality and efficiency while ensuring compassionate care. This management framework can support the reform of public hospitals in China and also serve as a reference for other countries.

Yi-Lin Zhang,1 Yan-Ping Wang,1 Tao Sun,2 Yi-Nan Tian,1 Xia-Xia Qin,1 Xin-Yu Duan,1 Yu-Tian Gan,1 Guan-Jun Wang,1 Li-Bin Yang,1,* Shu-E Zhang1,* 1Department of Health Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, People’s Republic of China; 2Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Li-Bin Yang; Shu-E Zhang, Department of Health Management, School of Health Management, Harbin Medical University, Harbin, 150081, People’s Republic of China, Email yanglib@126.com; hydzhangshue@163.comPurpose: Transformational leadership among core hospital leaders boosts medical organizations’ competitiveness, adaptability, and sustainability, which is jointly affected by individual, organizational and environmental factors. This study aims to unpack its configurational framework and propose strategies to strengthen core hospital leaders’ transformational leadership.Patients and Methods: Data were collected from an online questionnaire among 31 core hospital leaders. The fuzzy-set qualitative comparative analysis (fsQCA) was used to explore the causal mechanism of high-level transformational leadership. We enrich this mechanism by professional background, critical thinking, initiative spirit, family-work conflict, job satisfaction, subordinates’ followership, and work pressure.Results: Result shows initiative spirit is the only necessary condition (consistency=0.911) for the formation of high-level transformational leadership among core hospital leaders. Three configurations are the sufficient conditions that lead to high-level transformational leadership among core hospital leaders with two different professional backgrounds (overall solution consistency= 0.952).Conclusion: Core hospital leaders’ initiative spirit is an indispensable condition for improving high-level transformational leadership, emphasizing the necessity for core leaders to be proactive in order to develop such leadership. Besides, the study also uncovered three configurations are the sufficient conditions for core hospital leaders with diverse professional backgrounds to achieve high-level transformational leadership. This finding offers significant insights into hospital management practices, suggesting that core hospital leaders’ work should be managed in a personalized manner based on their professional backgrounds, thereby fostering favorable conditions conducive to the development of their high-level transformational leadership capabilities. Furthermore, the central insight of this study is that the formation of high-level transformational leadership contingent upon the collaboration of professional background, critical thinking, initiative spirit, family-work conflict, job satisfaction, subordinates’ followership, and work pressure, contributing to a holistic and more rigorous view for the development of transformational leadership.Keywords: transformational leadership, core hospital leaders, hospital management, configuration, fsQCA

Emergency actions taken by emergency departments concern a much larger context than the generally understood concept of saving human health and life. The excessive number of patients that must be admitted, due to the crisis situation, at a given moment of the department's operation results in the undertaking of specific actions and procedures. The occurrence of mass events cannot be planned or predicted, but it is possible to prepare for them in some way. Elaboration of the algo. The importance of preparing for crisis situations is increasingly discussed both in practical activities and in academic discussions. The problem concerns the small number of practical implementations of security management plans in crisis situations. The aim of the article is to present strategic activities in the field of management in crisis situations, based on the example of activities in the emergency department of a clinical hospital. A comprehensive crisis management plan allows to ensure the efficient functioning of the unit during emergency events, i.e. during actions in the event of an excessive number of incoming patients. Research and implementation work on preparedness for crisis situations is a need in the health care system on a macro scale.

Hind Alsahli,1 Ahmed M Al-Wathinani,2 Tariq A Althobaiti,3 Mohammed A Abahussain,2 Krzysztof Goniewicz4 1Pharmaceutical Care Division, King Faisal Specialist Hospital and Research Center, Riyadh, 11211, Saudi Arabia; 2Department of Emergency Medical Services, Prince Sultan bin Abdulaziz College for Emergency Medical Services, King Saud University, Riyadh, 11451, Saudi Arabia; 3Department of Emergency Medicine, King Khalid University Hospital, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia; 4Department of Security, Polish Air Force University, Deblin, 08-521, PolandCorrespondence: Ahmed M Al-Wathinani, Email ahmalotaibi@ksu.edu.saBackground: Patient safety is a critical concern in healthcare systems worldwide. Understanding the interplay between safety culture and incident reporting behaviors among healthcare professionals is essential for improving patient outcomes.Objective: To examine the perception of patient safety culture among healthcare professionals in Saudi Arabia and its impact on their attitudes toward incident reporting, considering variables such as level of care, ownership, and professional background.Methods: A cross-sectional survey was distributed both online and onsite to 453 healthcare professionals, with 402 completing it. The survey assessed various dimensions of safety culture and incident reporting behaviors. Statistical analysis included correlation matrices, regression models, and comparative assessments across different types of hospital settings.Results: The study revealed significant associations between perceived safety culture and incident reporting behaviors (p < 0.01). Specifically, management (B = 0.64, p < 0.01), working conditions (r = 0.51, p < 0.01), and job satisfaction (r = 0.52, p < 0.01) were identified as crucial for improvement. The study highlighted the importance of fostering a blame-free culture and establishing clear reporting guidelines to enhance reporting frequencies.Conclusion: Enhancing the perception of patient safety within healthcare settings positively influences the likelihood of incident reporting. Strategic interventions aimed at improving safety culture could significantly advance patient care quality.Keywords: patient safety, safety culture, incident reporting, healthcare professionals, Saudi Arabia, hospital management, cross-sectional survey

This study investigates the implementation of clinical pathways (CPs) for pediatric Dengue Hemorrhagic Fever (DHF) inpatients at Hospital X, a Type C hospital in Indonesia, focusing on the role of management in CP development and compliance. Clinical pathways aim to enhance hospital efficiency, quality of care, and patient satisfaction. However, the study identified several issues in CP implementation, including incomplete documentation, lack of socialization and training among staff, and inadequate managerial involvement in CP development and oversight. Data were collected through in-depth interviews with attending physicians, nurses, pharmacy staff, and medical management, along with analysis of 53 pediatric DHF CPs. Results showed that CP compliance rates were below 80%, and the hospital's organizational role in CP development, as assessed by the ICPAT dimension 6 instrument, was insufficient. Key areas of non-compliance included lack of evidence of clinical governance, integration with other hospital initiatives, and adequate support for CP documentation and variation reporting. Recommendations include increasing management involvement, providing comprehensive training for staff, and implementing regular CP evaluations. The findings highlight the need for stronger multidisciplinary collaboration and hospital management support to optimize CPs, ensure compliance, and improve service quality.. [ABSTRACT FROM AUTHOR]

Epidermolysis bullosa (EB), characterized by skin fragility and blistering, often requires hospitalization. Training for inpatient management of EB is limited, with no unified recommendations available in North America. To develop consensus-derived best practices for hands-on inpatient management of EB in both the neonatal and postneonatal period. A modified Delphi method (expert-based input via 2 surveys and a final review) was implemented. Available guidelines from EB Clinical Research Consortium centers were analyzed to determine areas of focus and formulate statements to be voted on by EB Clinical Research Consortium members, experienced EB nurses, and select family members. Study participants evaluated statements using a Likert scale: statements with at least 70% agreement were accepted; statements with 30% or more disagreement were rejected. Ten areas of focus were identified. Delphi participants included 15 dermatologists, 8 nurses, and 6 nonhealth care caregivers. Consensus was established on 103/119 neonatal statements and 105/122 postneonatal statements; no statements were rejected. Most recommendations applied to both age groups. Recommendations may require adjustment based on individual patient's clinical context. Using the Delphi method, a consensus-derived resource for hospital-based health care professionals who manage patients with EB has been developed to improve the quality of inpatient care. [ABSTRACT FROM AUTHOR]

Aims/Background: In an era where patient-centred care is paramount, effectively managing and analyzing hospital complaints is crucial for improving service quality and patient satisfaction. This study examines hospital complaints to enhance management practices by differentiating between surgery-related and non-surgery-related grievances. By identifying patterns in complaint types and outcomes, we aim to inform targeted quality improvement strategies that address specific patient concerns and boost operational efficiency. Methods: The study utilized data from an internal complaint management system over one year. Complaints were categorized as either surgery-related or non-surgery-related. Descriptive statistics and cross-tabulation analysis were employed to examine the data. The sample comprised 132 complaints, with 67 being surgery-related and 65 non-surgery-related. Results: The analysis revealed that surgery-related complaints frequently involved issues with 'Patient Communication' and 'Surgical Error', while non-surgery-related complaints were primarily about the 'Medical Treatment Process'. The Surgery Department received the highest number of complaints, indicating a critical area for intervention. Additionally, the correlation between complaint types and outcomes provided insights into potential areas for improvement. Conclusion: The findings highlight the need for targeted communication training and procedural enhancements in surgical departments. Non-surgical departments should focus on improving treatment protocols and transparency. These strategies can reduce complaints and improve patient satisfaction. Future research should develop and test interventions based on these insights to further enhance healthcare quality. [ABSTRACT FROM AUTHOR]

BACKGROUND: Organizational learning (OL) and interprofessional collaboration (IPC) are said to enhance medical safety in hospitals, but the relationship between these variables has not been quantitatively tested. OBJECTIVE: This study examines the mediating effects of IPC on the relationship between OL and safety climate (improvement, compliance, and patient/family involvement). METHODS: An anonymous self-reporting questionnaire was administered to 1,495 healthcare workers from November 2021 to January 2022. The questions regarded the hospital's safety climate, OL, and IPC. A mediation analysis using structural equation modeling was conducted to examine the mediating role of IPC on the relationship between OL and the three safety climates. The indirect effect was estimated using 2,000 bootstrap samples. RESULTS: Responses from 643 healthcare workers were analyzed. The direct effects of OL were =.74, 75 (p <.001) on improvement and involvement and = 0.1 (p >.05) on compliance. The indirect effects of IPC on improvement and involvement were =.14 (95%CI:.00 ∼.06) and =.37 (95%CI:.04 ∼.09), respectively. CONCLUSION: This study determined the mechanisms that enhance a hospital's safety climate, demonstrating that IPC mediates the relationship between OL and improvement and patient/family involvement. However, OL and IPC are not related to compliance. [ABSTRACT FROM AUTHOR]

This study highlights the development and application of a predictive analytics system in a Midwestern hospital to assess and manage the risk of patient readmissions within 30 days of discharge. By integrating advanced analytical modeling with electronic health records, the system enables the creation of personalized care plans by accurately predicting patients' readmission risks and the optimal timing for interventions. The results suggest that such models can significantly improve resource allocation and the personalization of care plans, thereby reducing unnecessary readmissions and aligning with value-based, patient-centered healthcare goals. Hospitals are responsible for ensuring not only that the patients heal when in the hospital but also that the patients are not readmitted within 30 days of discharge. Additionally, the penalization of hospitals from the Hospital Readmissions Reduction Program in the Affordable Care Act of 2010 and the emergence of value-based, patient-centered reimbursement models continue to pressure health organizations to minimize hospital readmissions. In the face of limited staffing resources, readmission strategies are driven by three foundational components: which patients to focus on, what type of intervention should occur, and when an intervention should occur. Previous modeling work has crudely grouped patients into a few segments. With the combination of advanced analytical modeling and widely used electronic health records (EHRs), patients' risk levels and the timings of the readmission issues can be finely predicted. This provides an opportunity for creating personalized care plans (when and what intervention should occur) for patients. This study describes developing and implementing a predictive analytics-based system in a Midwestern hospital system for profiling readmission risk. Results indicate that models, such as the ones detailed in this article, that combine patient stratification and readmission risk timing can effectively extend a personalized care plan to determine when intervention timing should occur and optimize resource allocation of the care team. This comprehensive suite of predictive models would allow care teams across the continuum to offer personalized care transition plans and dynamically pivot strategies to address emerging events throughout a patient's trajectory. History: This paper was refereed. [ABSTRACT FROM AUTHOR]

Logistics holds an important role in healthcare provision. One of the significant dimensions of logistics is the cost incurred for these activities. However, the cost of logistics is an overlooked issue in most healthcare organisations. The purpose of this study is to provide an insight into the cost of logistic activities in healthcare businesses. A case study was conducted in a medical centre in Istanbul. Historical data (second half of 2021) were used for the analysis. Activity-based costing method was adopted for cost calculation. In line with this approach, logistic activities of the medical centre were examined, and logistic activity centres were determined. Resource consumption of each centre was determined based on interviews with staff and records of the accounting department. Consequently, the costs of all logistic activities of the medical centre were calculated, and their share in the total cost of service production was determined. The total logistical cost of the healthcare centre was calculated to be ₺689,983. The cost of patient services and transporting activity centres accounted for 49% of total logistical costs. The costs of logistic activities accounted for 15.42% of the total cost of service. The results of the study show that logistic activities have a significant share of the total cost of service production in the medical centre. Activity-based costing is an effective way of calculating costs of logistic activities in healthcare services. Managers can use cost data to improve logistic processes. [ABSTRACT FROM AUTHOR]

Copyright of Human Factors in Design is the property of Universidade do Estado de Santa Catarina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To date, it is still largely unclear how the changes, as a result of Covid-19, affect the work environment and the perceived organizational and managerial context (OMC). Through a mixed methods design, this study aims, (1) to identify changes in the hospital OMC before and during the first wave of the Covid-19 crisis; (2) to further analyze and compare the impact of the crisis on the perceptions of the staff. For the quantitative phase, questionnaire measuring the OMC was used in Covid and Non-Covid wards. For the qualitative phase, we performed semi-structured interviews to identify positive and negative elements from the crisis management. Results from linear mixed models highlighted multiple tendencies following the Covid crisis. Differences appeared between Covid and Non-Covid units, with the latter showing greater difficulties following the crisis. A significant increase in participants' scores on interprofessional relationships was reported (P < 0.05). We found a significant decrease in job satisfaction (P < 0.001), absence of burnout (P = 0.001) and perceived efficiency of the service (P < 0.001). These findings suggest that hospital management strategies should aim at providing transformational leadership and information flow, as well as equal support for all working units, so that healthcare professionals feel motivated and work towards a shared meaning. [ABSTRACT FROM AUTHOR]

BACKGROUND: The COVID-19 pandemic has put health care systems of many countries under major stress. Due to its high transmission capacity, it has spread across the globe at a rampant pace. India is one of the countries which has been severely affected by COVID-19. It has posed onerous tasks in front of doctors. Along with it, it has left physical, social and mental implications on well-being of doctors. OBJECTIVES: The purpose of this study is to get an in-depth understanding about the implications of COVID-19 on physical, social and mental aspects of resident doctors in tertiary care hospital. METHOD: We performed a qualitative study which involved in-depth interviews of resident doctors who have worked during the COVID-19 pandemic from general medicine department of tertiary care hospital. Interviews were then manually transcribed and analyzed. RESULT: Data analysis by preparing transcript unveiled that doctors were constantly facing burnout and mental distress along with less social support. Our study also found that there was a shortage of resources and demonstrated poor doctor patient ratio which led to a decrease in efficiency of doctors. Our findings are not only confined to doctors facing burden but has also explored sanguine perceptions of resident doctors. CONCLUSION: While treating COVID-19 patients, resident doctors suffered a great setback. Providing them with mental aid, social support, ample resources and decreasing their work burden is recommended to effectively manage future pandemic. [ABSTRACT FROM AUTHOR]

The sustained political and managerial focus on cost containment and efficiency in hospitals has been altered by COVID-19-related concerns about public health. Through a novel qualitative study in Denmark, we explore CFOs' narratives of their experiences during a sudden shift in managerial logic. All of the CFOs describe engagement in key operational procedures and change management that was fostered by the constant search for stability that strongly depended on bottom-up decision-making and flexibility. During this process, the existing competing logics of managerialism and medical professionalism vanished. The CFOs describe new forms of dynamic and collaborative approaches. The possibility of adhering to the core logic of administrative accounting techniques combined with urgency and emotional encounters appears to enable this approach. Thus, we document a moment when well-known opposing logics were suspended by exogenous urgency. This finding suggests possibilities for moving beyond deep-rooted views on established public administration structures and logics. Points for practitioners: Financial managers show administrative skills that are useful for public administration changes in both administration and daily operations. These managers appear to have a strong core identity and willingness to dynamically engage with and facilitate acute frontline operational issues. In an emergency situation such as COVID-19, we find co-dependency across subject fields (administration and medical professions) which enables collaborations. [ABSTRACT FROM AUTHOR]

OBJECTIVES: This study aimed to assess the associations of pre-pandemic perceived work stressors and work satisfaction among nurses, including nurse assistants, with burnout profiles and their transitions in response to the pandemic. METHODS: Three hundred and thirty-seven nurses working in an Italian University hospital participated in a longitudinal study including a survey in August 2019 investigating perceived work stressors (assessed using the HSE Indicator Tool), work satisfaction (Work Satisfaction Scale), and burnout (Maslach Burnout Inventory), and a second survey in December 2020 assessing burnout. Using latent transition analysis, we identified burnout profiles and then estimated the associations between work stressors and satisfaction on profiles and transitions. RESULTS: We identified three pre-pandemic profiles, namely engaged (67%), ineffective (15%), and burnout (18%); and three pandemic profiles, namely engaged (37%), exhausted (51%), and severe burnout (12%). The severe burnout profile consisted of 70% nurses classified in the burnout profile before the pandemic. Overall, work stressors and satisfaction were associated with both pre-pandemic and pandemic burnout profiles. Among nurses not in the burnout profile prior to COVID-19, pre-pandemic hostile relationships increased [odds ratio (OR) 1.19, 95% confidence interval (CI) 1.05–1.34] and work satisfaction decreased (OR 0.82, 95% CI 0.68–0.98) the probability to transition to exhausted. Moreover, work satisfaction (OR 0.54, 95% CI 0.32–0.91) and participation in work organization (OR 0.69, 95% CI 0.51–0.93) protected from transitioning to severe burnout. The association between peer support and the transition to exhausted needs further investigation. CONCLUSIONS: Pre-pandemic work stressors and satisfaction were associated with pandemic burnout and burnout transitions. To enhance preparedness for future crises, healthcare managers should carefully assess and tackle work-related constraints affecting nurses.

This study aims to examine the impact of social media reports (SMR) on nurses' job satisfaction (NJS) and investigate the moderating effect of nurse manager overconfidence (NMO). Focusing on nurses in tertiary public hospitals in Guilin, China, we constructed an analytical dataset using survey data from January to June 2024 and social media comments collected through web scraping technology. Results reveal a significant positive correlation between SMR and NJS, indicating that increases in social media reports are associated with higher job satisfaction among nurses. However, when NMO acts as a moderating factor, the positive effect of SMR on NJS is attenuated, suggesting that overconfidence among nurse managers may diminish the influence of social media feedback. Furthermore, the study employs robustness tests, including the Replace Variables Method, Entropy Balancing Method, Instrumental Variable Method (IV-2LS), and Other Methods, effectively addressing endogeneity issues and confirming the reliability of these findings. This research offers theoretical support for enhancing hospital management and extends the literature on the moderating role of managerial characteristics on job satisfaction, providing practical insights for promoting high-quality hospital development.

Background: In hospital management, pinpointing steps that most enhance operating room (OR) throughput is challenging. While prior literature has utilized discrete event simulation (DES) to study specific strategies such as scheduling and resource allocation, our study examines an earlier planning phase, assessing all workflow stages to determine the most impactful steps for subsequent strategy development. Methods: DES models real‐world systems by simulating sequential events. We constructed a DES model for thoracic, gastrointestinal, and orthopedic surgeries summarized from a tertiary Chinese hospital. The model covers preoperative preparations, OR occupation, and OR preparation. Parameters were sourced from patient data and staff experience. Model outcome is OR throughput. Post‐validation, scenario analyses were conducted for each department, including: (1) improving preoperative patient preparation time; (2) increasing PACU beds; (3) improving OR preparation time; (4) use of new equipment to reduce the operative time of a selected surgery type; three levels of improvement (slight, moderate, large) were investigated. Results: The first three improvement scenarios resulted in a 1%–5% increase in OR throughput across the three departments. Large reductions in operative time of the selected surgery types led to approximately 12%, 33%, and 38% increases in gastrointestinal, thoracic, and orthopedic surgery throughput, respectively. Moderate reductions resulted in 6%–17% increases in throughput and slight reductions of 1%–7%. Conclusions: The model could reliably reflect OR workflows of the three departments. Among the options investigated, model simulations suggest that improving OR preparation time and operative time are the most effective. [ABSTRACT FROM AUTHOR]

Rome is vulnerable to chemical, biological, radiological, nuclear, and explosive (CBRNe) attacks. The study evaluates Rome's advanced emergency departments' state of emergency plans for massive influx of injures (PEIMAF) plans for CBRNe attacks. We propose a chemical attack on Saint Peter's Square during the Pope's General Assembly and its effects. The National Stockpile Antidotes' activation and territorial distribution timing work well for chemical attacks. We also estimated activation timing. Our data show that despite a good organization, travel times can be improved. We also believe that all major Roman hospitals must develop the PEIMAF, which should be followed by an organized training plan involving theoretical teaching and indoor and outdoor simulation to train hospital staff and evaluate PEIMAF weaknesses and vulnerabilities. The effectiveness and efficiency of first aid depend on timing, and each PEIMAF analyzed, while coherent and adequate for internal purposes, fails to integrate with the other hospitals. Integration can speed up National Stockpile Antidotes delivery and save lives. For the best CBRNe response, detailed intervention protocols must be created, updated daily, and exercised. [ABSTRACT FROM AUTHOR]

The article informs about the association between pre-pandemic perceived work stressors and work satisfaction among nurses with burnout profiles and their transitions during the pandemic. Topics include identifying burnout profiles, assessing associations with work stressors and satisfaction, and implications for healthcare organizations in addressing work-related constraints affecting nurses.

Background: A Sharia Hospital in Central Java of Indonesia had previously used a balanced scorecard (BSC) to assess hospital performance. However, BSC has not been integrated into the hospital's strategic management process. Purpose: This study aims to develop a Sharia Hospital’s strategic plan by adopting a BSC integrated into Islamic values. Design/methodology/approach: A qualitative study was conducted involving a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis with 10 respondents and focus group discussions with 11 strategic planning teams. Findings/Result: The results indicate that the hospital has completed several stages of developing a strategic plan, including defining the hospital's vision and mission, conducting a SWOT analysis, and formulating strategic objectives. Moreover, BSC has been implemented into the hospital's strategic planning process, particularly in formulating strategic objectives aligned with Islamic values. This reveals that the BSC has been integrated into the hospital’s strategic management process. Conclusion: The result of this study provides a reference for a Sharia Hospital to adopt BSC aligned with Islamic values in the preparation of a hospital strategic plan. By integrating Islamic values into BSC, the hospital can formulate and implement strategies and evaluate the hospital's performance more comprehensively and measurable, covering financial and non-financial performance while promoting Islamic values. Originality/value (State of the art): Developing a strategic plan using the BSC is commonly conducted, but integrating Islamic values into the BSC perspective is still relatively uncommon. Hence, this study contributes significantly to hospital strategic management practices, particularly in Sharia hospitals. [ABSTRACT FROM AUTHOR]

Hospitals, as critical infrastructures, confront multifaceted challenges during crises, ranging from natural disasters to pandemics. Initially, these facilities must secure essential emergency support functions and, subsequently, expedite their recovery from any adverse impacts. Hospital resilience, influenced by numerous variables and assessed through various evaluation criteria, remains enigmatic in terms of relationships and hierarchy among these factors. By integrating group decision‐making and interpretive structural modeling, this study delves into determinants of practices bolstering hospital resilience from an internal management perspective. While the empirical results offer insights specific to the study context, the primary contribution is in the innovative methodology that shifts the emphasis from mere outputs to the intrinsic value of the process itself. Consequently, a hierarchical model of hospital resilience emerges, enriching insights into hospital resilience and highlighting the intricate balance between methodological rigor and tangible application, additionally serving as a blueprint for similar context‐specific investigations. The research culminated in a consolidation session with an external expert, who assessed the model's applicability as a tool for generating new knowledge about developing hospital resilience management. Advantages and limitations are also discussed. [ABSTRACT FROM AUTHOR]

Proactive control of hospital processes significantly influences patient performance and satisfaction. The objective of the research is to develop a dashboard for the evaluation of patient flow management in hospital institutions. Descriptive quantitative study was developed and previous methodologies were analyzed. A procedure was developed for the preparation of a dashboard for the evaluation of patient flow management in hospital institutions, structured in five stages and nine steps, including procedures for the identification of key variables and aggregation of indicators. A dashboard was prepared for the General Surgery service of a Clinical Surgical Teaching Hospital, which is composed of 18 indicators, 6 synthetic indexes and an integral indicator. The integral indicator obtained a value of 0.79 (4), which shows the effectiveness of the actions implemented during the deployment of the improvement model. Among the positive implications for health managers is the possibility of monitoring strategies with a process vision. [ABSTRACT FROM AUTHOR]

This research is to test whether the combination model (CM) (combining cardiac rehabilitation (CR) with other cardiovascular medical services) impact patients' readmissions, physical and psychological outcomes. We found that CM significantly enhances patients' exercise ability and psychological condition and reduces readmission rates after discharged from the hospital, compared to patients that are admitted to non-CM. Departments' physical resources weaken the impact of CM on patients' physical outcomes and readmission rates while increasing patients' psychological conditions. Human resources strengthen the impact of CM on patients' readmission rates while reducing the impact on patients' physical outcomes. Our results provide empirical evidence for hospital resource constraints puzzle and reallocation. These results provide a possibility of introducing CM as a way to deal with CR implementing challenges. What we already know The impact of service models (such as healthcare integrations) on hospital- and patient-level outcomes has been empirically verified. Scholars demonstrate that cardiac rehabilitation (CR) can improve secondary prevention outcomes with comprehensive risk reduction and long-term care, but there are still barriers and challenges to implement CR. Prior studies show hospital resources have significant impacts on practices implementing, patients' satisfaction and readmission rates. What this article adds We extend the research on service providing field. Patients choose combination model (CM), which significantly enhances their exercise ability and psychological condition. Their readmission rates are also reduced. Higher departments' physical resources diminish the reduction of patients' admission rates, and human resources strengthen the reduction of patients' readmission rates. These results suggest that CM benefits patients' outcomes, and department resources favor certain outcomes. [ABSTRACT FROM AUTHOR]

The goal of every organisation is to have employees with high self-esteem and employees with a good work-related quality of life (WRQoL), given that such employees are more satisfied and provide better service, which is ultimately a benefit for the organization. In order for employees to have the best possible WRQoL, the responsibility lies with the administration or health system of a particular country, which is obliged to improve the organisation in all aspects. A sample of 409 participants in the Children's Hospital Zagreb examined their self-esteem and WRQoL. The research included both health and non-health employees. For the purpose of the research, the Rosenberg self-esteem scale and the WRQoL scale were used. The Pearson correlation coefficient between these two variables was calculated, which is the first such study. The results showed that we have employees with a high level of self-esteem, which is an excellent resource given the fact that high self-esteem has positive implications for job satisfaction and job performance. In contrast to self-esteem, employees were extremely dissatisfied with the quality of life-related to work, especially in the following categories; Working Conditions, Job and Career Satisfaction, and Control at Work. Following the above, and qualitative research, key factors were found that the management needs to address to raise the WRQoL of employees. [ABSTRACT FROM AUTHOR]

Accepted by: M. Zied Babai In the medical service system, when the number of expert seats is in short supply, it is difficult to make full use of hospital resources by the traditional queuing method. Without changing the existing resources, an overflow model with triage in a Markov queuing system is established by overflowing a part of patients in the expert queue into the general queue under a certain condition to allocate reasonably the capacity of each outpatient. The numerical simulation using ProModel, a simulation software, shows that the average queue length, waiting time and other service indices are better than the traditional models. [ABSTRACT FROM AUTHOR]

Medical social work plays a pivotal role in ensuring comprehensive and quality healthcare delivery, particularly in hospital settings. This paper delineates the multifaceted responsibilities undertaken by medical social workers, encompassing ethical treatment, transparency in hospital management, and advocacy for the welfare of vulnerable patients. It examines the historical evolution of medical social work in India, tracing its roots to the pioneering efforts of institutions like the Dorabji Tata Graduate School of Social Work. Furthermore, it elucidates the guidelines set forth by the Medical Council of India, emphasizing the critical need for medical social workers in both rural and urban healthcare facilities. In exploring the possibility of establishing dedicated departments for medical social work, this paper proposes a complementary framework to the existing department of community medicine. By delineating the roles and responsibilities of medical social workers in rural and urban health training centers, it underscores their significance in addressing community health determinants and facilitating access to essential services. It also highlights the potential for medical social workers to contribute as multidisciplinary team members across various hospital departments, thereby amplifying their impact on patient care and rehabilitation processes. In conclusion, the paper underscores the imperative of recognizing and strengthening the role of medical social workers in healthcare delivery systems. By fostering greater awareness, professional development, and institutional support, we can harness the full potential of medical social work to promote health equity and social justice for all individuals. [ABSTRACT FROM AUTHOR]

Purpose The public hospitals are not-for-profit entities, and their purpose is not to generate and distribute profits as a result of business activities. Therefore, in the context of hospital management, where many hospitals are running into losses and improving profitability has become a major issue, it is necessary to study the relationship between operational performance and profitability. Design/Methodology/Approach: In this study, targeting public hospitals, an empirical study was attempted on the correlation between operational performance and profitability. The 303 hospitals were analyzed for the financial years 2022 and 2023. To confirm the validity of the results for the entire group of public hospitals (population), including hospitals other than those subject to this analysis, an uncorrelated test was conducted. Findings: As a result, there was a positive correlation between the volume of surgeries performed and profitability. On the other hand, the shortening of the average length of hospital stay did not lead to an improvement in profitability. Profitability improved as the number of inpatients per physician increased, but there was no correlation between the number of outpatients per physician and profitability. Conclusion: The results of this study suggest the importance of index correction. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to analyse and detail surgical process improvement activities that achieve the highest economic impact. Methods: Over 4 years, a team of technicians and healthcare professionals implemented a set of Lean surgical process improvement projects at Vall d'Hebron University Hospital (VHUH), Barcelona, Spain. Methods employed in the study are common in manufacturing environments and include reducing waiting and changeover time (SMED), reducing first time through, pull, and continuous flow. Projects based on these methods now form part of the daily routine in the surgical process. The economic impact on the hospital's surgical activity budget was analysed. Results: Process improvements have led to annual operational savings of over EUR 8.5 million. These improvements include better patient flow, better management of information between healthcare professionals, and improved logistic circuits. Conclusions: The current cultural shift towards process management in large hospitals implies shifting towards results-based healthcare, patient-perceived value (VBHC), and value-added payment. A Lean project implementation process requires long-term stability. The reason a considerable number of projects fail to complete process improvement projects is the difficulty involved in establishing the project and improving management routines. Few studies in the literature have investigated the economic impact of implementing Lean management a posteriori, and even fewer have examined actual cases. In this real case study, changes to surgical block management were initiated from stage zero. After being carefully thought through and designed, changes were carried out and subsequently analysed. [ABSTRACT FROM AUTHOR]

In a hospital, keeping track of patients and their needs is a multi-faceted nightmare. Each department has its own intake and check-out process, and all of this information must be in one central place. That’s why there are so many hospitals that are struggling to confirm the organization of patient data. There are several of Machine Learning algorithms that can help to optimize patient flow in hospitals, provide a real-time presentation of department workflow. This editorial will examine some of the most effective ML algorithms to solve these issues. Before we dive directly into the solutions, it is important to understand how ML can help specifically in the healthcare industry. The increased adoption of ML stipulates a wide range of new technologies and applications that would transform medicine. These healthcare developments would help providers to offer care tailored to the individual needs of patients, making treatment more effective and affordable. Although the actual impact of the algorithms on healthcare is still a subject of future research, the expected outcomes are huge. Before analyzing how they work, it is important to explain the terminology. Specifically: data mining is the manner of discovering new data or knowledge from huge amounts of data. The major focus of data mining is made on unstructured data, as e.g. medical records, social media posting or images. Machine learning implies a computer program that is trained on data to find patterns and make predictions.1 There are many types of ML algorithms, but they all have three steps in common: • Training: create a model using the data. • Use the model to make predictions. • Tune the model to get the best results. Natural Language Processing (NLP) is a type of machine learning that allows computers to understand human language.2 Health care providers use NLP to meet patients’ needs, goals, and expectations. One of the many problems in hospitals is the inability to manage patient flows through various departments and check-out points. The problem is that when patients arrive at a hospital, they can be instructed to go to the Emergency Department. They can also be told to go to a different department based on the results. In spite of the fact that it is necessary for there to be a single source of information, regardless of the department, in order to ensure that both patients and staff have access to the same level of information.3 It would be ideal to have a centralized location that provides information on the department's current availability, wait times, and staff members' status. In order to enhance the efficiency of patient flow within the hospital, administrators and healthcare providers can utilize machine learning algorithms to gather information regarding patients' arrival, departure, and current condition. In addition, it is able to evaluate the condition of each individual patient and give staff with information in real time. This strategy makes it easier to control the flow of patients in an effective manner, which in turn enables staff members to concentrate on the activities that are most important to them. There are a great number of data sources that can be operated in order to collect information regarding the conditions of patients. To ensure that activities are carried out in the most effective manner possible, it is essential that staff members have instant access to these resources. Natural language processing, often known as NLP, is a method that is utilized for the retrieval of information that is very effective. Natural Language Processing (NLP) has made it possible for computers to grasp human language. This capability was first introduced in 2005. They are able to collect vital information from a patient's report and incorporate it into the centralized system in a seamless manner.4 Because of this, the system is able to collect and store information about the diagnoses, treatments, prescriptions, and other pertinent information pertaining to patients. In addition to providing patients and staff members with real-time updates on the situation, the data may be employed to provide precise estimations of the amount of time that patients will be required to wait. In addition to this, it is able to recognize and assess patterns and trends within the process of the department, thus allowing the required adjustments to be made in order to improve efficiency. After collecting data from patients, it is possible to analyses trends and patterns within the data. The investigation has the potential to improve patient care by highlighting areas for improvement. Using an acceptable sample size, it is possible to make reliable predictions about the likelihood of specific occurrences. The use of a machine learning algorithm allows for the assessment of the likelihood that persons with specified conditions will be discharged or admitted to a medical facility.5 The use of these algorithms is critical in giving invaluable assistance to workers in the performance of their everyday activities, as well as predicting and anticipating the state of patients. The rapid examination of data has various advantages, notably in terms of minimizing wait times. The provision of timely help is an important part of controlling patient flow because it has a direct impact on patient satisfaction and likely to recommend the healthcare institution. The implementation of an automated system for data collection and analysis can assist hospitals in attaining transparency. To augment transparency within the healthcare facility, administration may elect to employ machine learning algorithms to produce status dashboards.6 This type of dashboard has the capability to deliver instantaneous updates regarding the condition of facilities and departments. It can provide details such as staff availability, wait times, and the individual patient loads of each staff member. There are specific situations in which the implementation of a decentralized system is required to assure hospital-wide transparency. Particularly designed chatbots may be employed in such circumstances to collect data and provide immediate transparency. A chatbot that is purpose-built for the hospital environment can efficiently respond to fundamental inquiries, collect critical data, and improve patient transparency. By employing ML algorithms, the efficacy of patient flow can be significantly enhanced. Conflict of interest: None declared.

A concerning number of hospitals have closed in the US in recent years and there are many other hospitals that are at significant risk of closure in the coming years. The COVID-19 pandemic magnified the trend of hospital closures, raising further concerns about the potential impacts of hospital closures and the important need for devising policies that can mitigate them. To devise such policies, however, we first need to better understand the main drivers, potential adaptations by providers, and the widespread public impacts of hospital closures. We also need to recognize various changes in care delivery modes and related practices. Understanding these complex issues can allow policymakers to shift their focus from the narrow scope of “access to care,” and instead take into account various other consequences of hospital closures that are currently largely overlooked but need to be part of policy discussions.

One of the most common causes of maternal deaths during pregnancy is preeclampsia. As a result, it is critical to consider the resources required to provide timely care and avoid health complications. One of those resources is hospital beds. Thus, to explore in-depth the inpatient beds occupation to treat preeclampsia at the IESS Los Ceibos Hospital in Guayaquil-Ecuador, Descriptive, Diagnostic, Predictive, and Prescriptive (DDPP) analytics will be applied together to the medical records collected retrospectively. In the descriptive analysis, the effects of the COVID-19 pandemic can be seen during the period March-September 2020. The diagnostic analysis helps us to show a consistent upward trend in the time series. In the predictive analysis, techniques such as Dynamic Bayesian Networks (DBN), Multilayer Perceptron (MLP), and Long Short-Term Memory (LSTM) are considered to forecast the future inpatient bed occupation. The model trained with MLP achieved the lowest MAPE, which was 11.58%. It predicts that in September and November of 2024, there will be peaks of 274 and 258 inpatient beds, respectively. Finally, in our prescriptive analysis, we show that closing the hospitalization unit would produce, on average, 130.33 monthly referrals. To our knowledge, we do not find any work that applies all the DDPP analytics together in preeclampsia. Moreover, to our knowledge, this is the first study that makes a joint application of DDPP analytics in univariate time series. Therefore, this work may serve as a basis for future studies in the joint application of all DDPP analytics to time series and to health.

Abstract Background Hospital chief financial officer (CFO) contributes to improving health system performance. However, how to become an excellent hospital CFO has rarely been considered from a holistic perspective. This paper aims to identify competencies required by hospital CFO to fulfil the position’s responsibilities and explore effective implementation pathways to generate high performance and improve healthcare service. Methods We conducted 61 semi-structured interviews with individuals in key leadership positions in China’s hospitals and researchers focusing on healthcare system management to identify core competencies necessary for hospital CFO. Interviews were analysed through a multi-stage review process and modified via expert vetting using a national panel of 23 professors. Subsequently, interviews were conducted with 32 hospital CFOs from 14 provinces throughout September 2021 to May 2022. We scored the performance of 32 hospital CFOs in various aspects of competency and used the fuzzy-set qualitative comparative analysis to explore the competency configurations of excellent CFOs. Results We identify seven core competencies necessary for a hospital CFO to fulfil management practices, including personal morality, resource management, strategy management, learning ability, negotiating skill, leadership skill, and financial management. The findings indicate that a single competency factor is not a necessary condition to become an excellent hospital CFO. The results of qualitative comparative analysis then make it possible to propose four configurational paths, namely, supportive, interpersonal, all-around development, and technical, to become an excellent hospital CFO and achieve effective managerial performance. Conclusions The responsibilities of hospital CFOs are complex and varied, hence, a better understanding of competencies required by CFO is essential to implement their responsibilities effectively. The identification in this study of the four effective implementation pathways to becoming an excellent hospital CFO enriches the literature on hospital management and provides implications for China’s hospitals and their CFOs.