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Kaizen initiatives are core organisational mechanisms in lean healthcare projects. Although they show specific peculiarities (e.g. a narrow goal and an accelerated timeframe), they can vary in the way they are planned and executed. This study investigates what types of configurations of kaizen initiatives (profiled as gestalts of specific characteristics) can exist in healthcare, if they differ for social and technical outcomes, and for their application context (here considered in terms of work area routineness and team composition). The study is based on data from 362 participants to 105 kaizen initiatives implemented in two public hospitals in Italy. It identifies three clusters (i.e. 'hard practices-oriented', 'soft practices-oriented' and 'full-lean adherent' kaizen initiatives) characterised by different social and technical outcomes. The original contribution to the lean healthcare literature is twofold: first, the simultaneous focus on performance improvement (technical outcome) and modification of operators' mindset (social outcome); second, the adoption of a configurational approach to understand how gestalts of many variables explain the dynamics that lead to social and technical outcomes. No significant differences were found among clusters in terms of work area routineness and team composition, which also opens interesting directions for future research. [ABSTRACT FROM AUTHOR]

Hospital waste stands as a distinct and hazardous category due to its potential inclusion of infectious and contaminated elements, posing severe threats to the environment and public health. Understanding the quantity and nature of hospital waste is pivotal for effective management. The primary objective of this study was to assess the practices of waste management adopted at a charitable hospital in Palestine, in addition to waste quantification and characterization. Over the course of seven consecutive days, solid waste produced within a 24-h cycle was collected, weighed at 2-h intervals from various hospital departments, segregated, and classified into general and medical waste. Getting to know such detailed information has never been known before, making the study distinctive. Hospital averaged 1.38 kg medical, 2.42 kg general waste/bed/day, totaling 3.80 kg solid waste/bed/day. The maximum amount of medical waste was between 6:00 and 8:00, while the maximum amount of general waste was from 12:00 to 14:00. The medical waste generated on 2-h intervals represented 36.5 (by weight) and 29.2% (by volume) of the total solid waste. The study highlighted deficiencies in waste management practices at the hospital, notably the absence of proper segregation as per the World Health Organization guidelines. Medical waste was disposed of alongside household waste without appropriate handling or treatment. There were clear inadequacies in the hospital's approach to medical waste management, primarily due to improper waste segregation at the source, inadequate waste collection and storage methods, and insufficient financial and human resources allocated to ensure proper management. [ABSTRACT FROM AUTHOR]

A nation's overall development depends critically on its people's health. It becomes essential to maintain an efficient and comprehensive health policy and legislation that guarantee broad application and efficient remedies. Numerous issues hamper India's healthcare system. To mention a few, increased expenses, lack of skilled employees, ineffective systems for prompt action, etc. Since "public health" is a state subject, the enactment regulating hospitals is basically done by the states. As of now, there are eight states with a public health law or draft in place. Many of these laws have been ineffective. There is no second opinion on the fact that any new law will bring huge expenditures to the state's exchequer. Nonetheless, there is strong scientific evidence that the law can help improve public health. Access to public health is one of the government's Directive Principles of State Policy under the Indian Constitution. India has one doctor for every 1445 Indians, compared to the WHO's norm of one doctor per 1000 people. The private hospital management system is subsidized and supported, resulting in rising healthcare prices. According to NITI Aayog, medical costs cause roughly 7% of Indians to fall below the poverty line each year. These statistics beg for prudent management of resources in health care. The purpose of this research is to find out or, if required, develop a strategy to bring synergy between the hard and soft laws in the field of healthcare management. The methodology adopted for this research is doctrinal with critical analysis. [ABSTRACT FROM AUTHOR]

Background: Variation in perioperative care persists globally. Consensus discussions may facilitate standardisation, yet the processes used to reach agreement are poorly understood. This study aimed to develop a model for conducting local consensus discussions when implementing standardised perioperative pathways. Specifically, we 1) describe how local consensus discussions are operationalised; 2) identify what guides decision making and consensus between clinicians; and 3) formulate explanatory mechanisms and identify determinants that facilitate consensus discussions. Methods: A qualitative, modified grounded theory study was conducted in one private hospital in metropolitan Sydney, Australia. Thirty-one participants from clinical disciplines and hospital management/leadership were included. Data were collected from nine semi-structured interviews and 16 h of participant observations during consensus development or implementation meetings. Data collection and analysis occurred concurrently until theoretical saturation was achieved. Interviews and field notes were recorded and transcribed verbatim. Data were analysed using coding, constant comparison, detailed memo writing and data interpretation. Results: Seven individual and contextual factors crucial for building consensus, and eight mechanisms for reaching agreement were identified and integrated into a conceptual model. Seeking evidence to support decision-making emerged as the primary driver of consensus. Strong research evidence in support of a pathway component facilitated swift agreement. Where there was ambiguous evidence for a pathway component, clinicians based their decisions on a desire for professional autonomy, consideration of how their peers practice, patient preferences, practices from external organisations, or the feasibility of implementing the pathway component. Conclusions: The Consensus Model for Standardising Healthcare provides a map for healthcare organisations seeking to conduct local consensus discussions to reduce variation in care. Our findings advance our understanding of how local consensus discussions are conducted and factors that impact success when standardising care amongst clinicians. [ABSTRACT FROM AUTHOR]

Purpose To describe diagnostic approaches and management strategies for patients with primary hyperparathyroidism (PHPT) and recent fracture in England. Methods We developed a survey based on a patient at high fracture risk and a new diagnosis of probable PHPT. The survey was circulated among 50 secondary care professionals identified by the Society for Endocrinology Calcium and Bone special interest group. Descriptive statistics, combinatorial, and thematic analyses were employed. Results In the patient with hyperparathyroidism and a recent fracture, 54% of respondents favoured a 24-hour urinary calcium: creatinine clearance ratio, with 85% opting to do so after correcting vitamin D levels. Thirty-two percent (16/50) preferred the spot urinary calcium:creatinine clearance ratio, as a random test (56%, n = 9/16). Ninety-six percent of the respondents agreed they would include a fracture risk assessment in their management plan. Eighty-five percent of the respondents selected dual-energy X-ray absorptiometry scans of the lumbar spine, total hip, and femoral neck as the most popular choice. Before initiating antiosteoporotic medications (AOMs), 94% of the respondents preferred correcting vitamin D levels with diverse regimens. IV zoledronate acid was the preferred AOM, and 58% (n = 29/50) supported cinacalcet usage if the patient was ineligible for parathyroid surgery, while 26% (n = 13/50) opposed cinacalcet use entirely. No significant correlation was found between status as an endocrinology consultant or working in a tertiary care hospital and these management preferences. Main Conclusion This study of National Health Service medical staff identified highly-varied clinical practices in managing PHPT in the setting of high fracture risk, highlighting the need for pragmatic guidelines and wider education. [ABSTRACT FROM AUTHOR]

Background: A competent management workforce is crucial to achieve the effectiveness and efficiency of health service provision and to lead and manage the health system reform agenda. However, the traditional recruitment and promotion approach of relying on clinical performance and seniority provides limited incentives for competency development and improvement among hospital managers in Iran. There is limited evidence on the competency development needs of hospital managers in Iran that can guide setting training and development direction. This study aims to identify the competency development needs of three management levels (senior, mid-level, and frontline) in public hospitals and explore the difficulties that managers experienced. Methods: The study adopted a cross-sectional survey using the validated management competency assessment partnership (MCAP) tool. The MCAP tool, consisting of 82 behavioral items that measure six core management competencies, was distributed to 162 public hospitals in 19 provinces in Iran between September 2021 and March 2022. The data were analyzed using descriptive and inferential statistics including the mean and standard deviation, chi-square test, independent-samples t-test, and one-way analysis of variance. Results: In total, 1051 managers completed the survey either online or on paper. Peer and team conflict, employee performance, loss of skilled staff, and supervisor confrontation were the five difficulties most often encountered by all three levels of managers. The survey confirmed that only a small proportion of managers had the opportunities to participate in formal and informal management-related education/training, such opportunities were much lower for middle and frontline managers (P < 0.001). Middle managers were less confident in their demonstration of the core management competencies than that of senior and frontline managers (P < 0.001). Managers who completed management training organised internally by the hospitals consistently received higher mean competency scores for all competencies (P < 0.001). Conclusion: The study provides compelling evidence highlighting the importance of developing strategies to systematically enhance the capabilities of hospital managers, particularly mid-level managers. Incentives to encourage hospital managers to participate in both formal and informal management training, along with the commitment from hospitals to establish mechanisms that build management capacity, support managers, and guide the preparation and recruitment of management positions, are essential. [ABSTRACT FROM AUTHOR]

Background: Israel is unique in offering a formal subspecialty in Medical Administration and mandating it for physicians applying for senior roles. Data on the prevalence and characteristics of these specialists are limited. Methods: The national registry of licensed physicians was used to identify all living physicians who completed the Medical Administration subspecialty by December 31, 2022. Data on year of medical licensing, city of residence, and list of additional recognized specialties along with their respective date of completion were extracted. Websites of key public health organizations were sampled to identify qualifications of persons in senior leadership positions. Results: Since 1987, 277 physicians have completed the Medical Administration subspecialty, with a significant increase in annual certifications from 4.5 in 2015 (interquartile range [IQR] 4–6) to 13 (IQR 10.5–15) in 2022 (p < 0.001). Specialists completed the subspecialty a median of 18 years (IQR 13–21) post-licensing, with 269 physicians (97.1%) holding additional specialties, primarily in Internal Medicine, Pediatrics, Family Medicine, or Public Health. Compared to the general physician population, some base specialties like Public Health are over-represented while others, like Anesthesiology, are under-represented. Only 40 (14.4%) specialists reside outside major metropolitan areas. Nineteen (61.3%) general hospital CEOs, 2 (20%) psychiatric hospital CEOs, 13 (35.1%) Ministry of Health and 4 (7.8%) Sick Fund executives are specialists in Medical Administration (p < 0.005). Conclusions: The steady growth in the number of specialists in Medical Administration demonstrates the sustainability and scalability of this model, which may serve as a template for other healthcare systems. However, the limited representation of these specialists in senior roles of some organizations, and their concentration within certain specialties and regions, indicates areas for policy attention to enhance leadership diversity and reduce healthcare disparities. [ABSTRACT FROM AUTHOR]

Background and aim: The perennial underperformance of the Nigerian Health System necessitated enhanced advocacy for health to be placed at the centre of a renewed social contract and as a means of bolstering public trust. The hospital management of the University of Nigeria Teaching Hospital (UNTH) introduced initiatives to improve the hospital's operational environment and service performance in response to the population served. Following these changes, an Organizational Capacity Assessment (OCA) is critical to direct further development in the organization. Methods: A comprehensive Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis was conducted for the UNTH across twelve broad areas. The Modified Delphi Technique was adopted for the identification and prioritization of the organizational SWOTs. Thirty key stakeholders and leaders in the organization were first consulted to identify the SWOTs. This was followed by a structured ranking of the SWOTs by 109 staff of UNTH to isolate the priority assets and needs of the organization. Results: The top strengths were mainly related to the hospital's resources like its large expanse of land, staff capabilities like their skills and training, as well as their prevailing language, and existing hospital partnerships. The identified weaknesses were associated with challenges such as transportation for staff to work, infrastructure (lack of staff accommodation and office space), and health workforce shortages due to migration. The highest ranked opportunity was in the Epidemiology and Disease Surveillance broad area while the highest ranked threat was in the leadership and governance broad area. Conclusion: This SWOT analysis has highlighted the strategic aspects of UNTH's operations. By identifying its internal strengths and weaknesses and external opportunities and threats, the hospital can thus formulate effective strategies to enhance its performance and maintain its position as a leading healthcare institution. [ABSTRACT FROM AUTHOR]

OBJECTIVE To investigate the phenomenon of moral harassment (mobbing) and the quality of professional life of the medical and nursing staff of the General Hospital of Pyrgos in Greece and the correlation between these two variables. METHOD The questionnaire was divided into three parts; the first part was related to the collection of demographic data, while the second and third part included the Leymann Inventory of Psychological Terror (LIPT) scale and the Professional Quality Of Life (ProQOL-5) scale, respectively. The research sample consisted of 103/130 (response rate: 79.0%) doctors and nurses and was held from January until March 2023. Data analysis was performed with the Statistical Package for Social Sciences (IBM SPSS), version 25.0. RESULTS The results showed that 56.4% of the medical and nursing staff have encountered one or more moral harassment behaviors in the last 12 months, while 63.8% of them reported that the incidents of moral harassment were caused by a colleague. Regarding the quality of professional life of medical and nursing staff, participants had a moderate-to-high level of compassion satisfaction, while having a low level of burnout and post-traumatic stress. Also, nursing staff without a position of responsibility and with a permanent or auxiliary job were more likely to have experienced moral harassment in the last 12 months, while the medical and nursing staff who had experienced moral harassment in the last 12 months had a significantly lower level of compassion satisfaction and a significantly higher level of burnout and post-traumatic stress. CONCLUSIONS The phenomenon of moral harassment exists in Greek hospitals and must be addressed by hospital administrations, through the planning and adoption of good practices to deal with the problem and the formation of a good professional life quality. [ABSTRACT FROM AUTHOR]

BACKGROUND: This study explores the influence of Diagnosis-Related Groups (DRG) payment reform on hospital cost control and offers pertinent cost management strategies for public hospitals. It situates the research by elucidating the significance of the DRG payment method and comparing its advantages and drawbacks with the traditional 'pay per project' model. OBJECTIVE: The primary aim is to assess the impact of DRG payment reform on hospital cost control and propose effective cost management strategies for public hospitals. The objective is to provide insights into DRG payment implications and attempt practical recommendations for its implementation in the public healthcare sector. METHODS: Employing a comprehensive approach, the study analyzes DRG payment, delineates advantages and drawbacks, and proposes cost management strategies. Methods include staff training, an information management platform, disease analysis, and optimized cost accounting. The study highlights the potential for improved medical diagnosis and treatment through industry-finance integration. RESULTS: Findings reveal advantages and limitations of DRG payment, emphasizing strategies for optimizing hospital operations. Enhanced medical diagnosis and treatment procedures through industry-finance integration contribute to overall cost control effectiveness. CONCLUSION: The study serves as a practical guide for implementing DRG payment reforms, offering valuable insights for policymakers and healthcare professionals in navigating the complexities of cost control in public healthcare. [ABSTRACT FROM AUTHOR]

Sepsis is a complex and potentially life-threatening syndrome characterized by an abnormal immune response to an infection, which can lead to organ dysfunction, septic shock, and death. Early diagnosis is crucial to improving prognosis and reducing hospital management costs. This narrative review aims to summarize and evaluate the current literature on the role of monocyte distribution width (MDW) as a diagnostic biomarker for sepsis, highlighting its advantages, limitations, and potential clinical applications. MDW measures the volumetric distribution width of monocytes, reflecting monocytic anisocytosis, and is detected using advanced hematological analyzers. In 2019, it was approved by the FDA as a biomarker for sepsis due to its ability to identify systemic inflammatory response at an early stage. Thirty-one studies analyzed by us have shown that an increased MDW value is associated with a higher risk of sepsis and that its combination with clinical parameters (such as qSOFA) and other biomarkers (CRP, PCT) can enhance diagnostic sensitivity and risk stratification capacity. Despite its high sensitivity, MDW has lower specificity compared to more established biomarkers such as procalcitonin, thus requiring a multimodal integration for an accurate diagnosis. The use of MDW in emergency and intensive care settings represents an opportunity to improve early sepsis diagnosis and critical patient management, particularly when combined with other markers and clinical tools. However, further studies are needed to define a universal cut-off and confirm its validity in different clinical contexts and pathological scenarios. [ABSTRACT FROM AUTHOR]

Echinocandin drugs are the current first-line therapy for fungal infections caused by Candida spp. Most patients require once-daily intravenous (IV) administration in a hospital or outpatient setting for treatment, which may negatively impact their quality of life and stress healthcare resources. Similar to other echinocandins, the novel FDA-, EMA-, and Medical and Healthcare Products Regulatory Agency-approved echinocandin, rezafungin (CD101), exhibited strong antifungal activity against several fungal pathogens and a low drug–drug interaction liability, which are important for medically complex patients. A pharmacometric-based approach has been adopted throughout the development of rezafungin, which contrasts with older echinocandins where dosing regimens were largely derived empirically, and only recently based on pharmacometric guidance. This state-of-the-art approach used model-based simulations incorporating pre-clinical and clinical data as it became available to optimize the dosing regimen for rezafungin. The enhanced stability of the molecular structure and the safety profile of rezafungin allow for the administration of once-weekly IV doses, compared to the daily dosing requirement for other echinocandin drugs, with this distinctive pharmacokinetic profile of rezafungin resulting in a front-loaded dosing regimen with high exposures early in therapy for enhanced fungal killing. The long shelf-life of rezafungin makes this echinocandin more flexible in terms of storage and manufacturing. Demonstrated across clinical development, rezafungin may provide patients with next-generation first-line antifungal treatment for the treatment of candidaemia and invasive candidiasis. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate whether continuous glucose monitoring (CGM) could assist providers in intensifying glycemic management in hospitalized patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: At six academic hospitals, adults with type 2 diabetes hospitalized in a non–intensive care setting were randomly assigned to either standard therapy with glucose target 140–180 mg/dL (standard group) or intensive therapy with glucose target 90–130 mg/dL guided by CGM (intensive group). The primary outcome was mean glucose measured with CGM (blinded in standard group), and the key secondary outcome was CGM glucose <54 mg/dL. RESULTS: For the 110 participants included in the primary analysis, mean ± SD age was 61 ± 12 years and mean HbA1c was 8.9 ± 2.3% (73.8 ± 1.6 mmol/mol). During the study, CGM-measured mean glucose was 170 mg/dL for the intensive group (n = 60) vs. 175 mg/dL for the standard group (n = 50; risk-adjusted difference −7 mg/dL, 95% CI −19 to 5; P = 0.25). Only 7% of the intensive group achieved the mean glucose target range of 90–130 mg/dL. CGM readings <54 mg/dL were infrequent (0.2% for intensive and 0.4% for standard; adjusted treatment group difference −0.1%, 95% CI −0.6 to 0.3). One severe hypoglycemia event occurred in the standard group. CONCLUSIONS: The study's glucose management approach using CGM did not improve glucose levels compared with standard glucose management in the non–intensive care unit hospital setting. A glucose target of 90–130 mg/dL may not be realistic in the current environment of insulin management in the hospital. [ABSTRACT FROM AUTHOR]

Objectives: The novel SARS-CoV-2 outbreak disrupted businesses globally and created fears in the general public and among health-care professionals. Almost universally, considerations about the coronavirus pandemic and its effects became priority in the daily operations of businesses, leaving hitherto pressing concerns in the back stage. Early in the pandemic, the management of University of Benin Teaching Hospital set up a Business Continuity Team which undertook an evaluation of the perceptions of mid-level hospital managers about their departments' and units' risks and vulnerabilities in the face of the ongoing pandemic. Methods: A modified International Labour Organization (ILO) risk profile self-assessment tool which focused on "people," "processes," "profits," and "partnerships" was used to assess mid-level managers' perceptions of their respective departments' and units' risks and vulnerabilities, consequent on the COVID-19 pandemic. Responses were obtained from heads of departments and units using an online survey. Final scores were divided into terciles (three equal groups) in respect of perceived risks and adverse outcomes of the COVID-19 pandemic. Scores in the lower tercile were grouped as low risk/vulnerability, the middle group of scores as medium risk/vulnerability, and scores in the upper tercile as high risk/vulnerability. Results: Responses were obtained from 35 (49.3%) of the 71 clinical and nonclinical departments and units in the hospital. Fifteen of these (42.9%) were clinical. Nineteen (54.2%) departments were assessed to be at high risk/vulnerability, 9 (47.4%) of which were clinical. Twelve (34.3%) departments were assessed to be at medium risk/vulnerability – 4 (33.3%) of them, clinical. No department was assessed to be at low risk. The highest risk ratings were in the domains of "profits" and "partnerships:" 54 (84.4%) mid-level managers assessed their departments and units to be at high risk of the negative impacts of the coronavirus pandemic with respect to "profits" and 51 (79.7%) with respect to "partnerships." Conclusion: Mid-level managers in clinical and nonclinical departments and units assessed their departments and units to be at medium and high risk of the negative impacts of the COVID-19 pandemic, using the ILO's modified tool. Our findings enabled the management of the hospital and the Business Continuity Team to address the specific areas of concerns that were highlighted, develop contingency plans, and frame risk communication during the pandemic, with a view to fostering increased sense of safety in the workforce. This approach to risk assessment is repeatable, and we recommended it to other hospitals in Africa. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: An induction training program is a structured process to acclimatize and orient the newly inducted staff or employees to an organization. As per the literature, there is no structured induction training program for resident doctors available in tertiary care teaching hospitals in India. Unlike other institutions, hospitals are complex places with several departments, processes, and patient services. Resident doctors in teaching medical institutions are a valuable human resource as they form the frontline doctors for delivering healthcare services. Therefore, the resident doctor needs to be oriented to the institution as early as possible to ensure quality in patient care services. The study aims to develop an induction training program for newly joined residents in teaching medical institutions and evaluate its effectiveness. The study setting was AIIMS, Bhubaneswar and the duration of the study was 6 months. Methodology: The ADDIE (analyze, design, develop, implement, and evaluate) model of human resource management was used as the study tool to develop the training program. An online national survey was conducted in the analyze phase to identify the training needs of residents. A comprehensive training module was developed based on the findings and referring the NABH Standards. The modules were implemented in a pilot mode in the study setting, and feedback was collected to understand the effectiveness of the program. Results: A training program for residents with 14 modules was developed and implemented. It consisted of 22 credits. The findings of the online survey and the feedback of the training program were found to be similar in many aspects though study participants were different in the analyze and evaluate phases. The Hospital Infection Control Practices, Hospital Management Information Systems, and Medico-legal Module were rated high by the residents. The study outlined the need for an induction training program for resident doctors in medical institutions. Based on the survey, the module was prepared and implemented. This module can be a model that can be replicated in other medical institutions. Conclusion: An induction training program for resident doctors was developed that helped them to get oriented to their workplace and improve their skills. This activity directly affects the quality of healthcare services thereby significantly contributing to patient safety. [ABSTRACT FROM AUTHOR]

This study aims to examine the influence of green human resource management (GHRM) and green supply chain management (GSCM) on triple bottom line performance in Indonesian hospitals, with a focus on the moderating role of green organizational culture and the mediating effect of GSCM. Primary data were collected from 850 functional procurement staff in hospitals under Indonesia's Ministry of Health through questionnaires distributed between March and June 2024. A total of 265 respondents were selected using disproportionate stratified random sampling based on the Krejcie method with a 5 percent margin of error. The data were analyzed using partial least squares structural equation modeling (PLS-SEM). The findings reveal that GHRM significantly enhances environmental and social performance but has no effect on economic performance. GSCM effectively mediates the relationship between GHRM and triple bottom line performance. Additionally, green organizational culture strengthens the relationship between GHRM and environmental performance but does not moderate its relationship with economic performance. The study highlights the importance of integrating green practices into hospital operations, particularly through eco-friendly employee training, supply chain efficiency, waste reduction, and the cultivation of a green organizational culture to promote sustainability. The study recommends the adoption of environmentally friendly practices to ensure long-term environmental health, social responsibility, and resource conservation in hospitals. [ABSTRACT FROM AUTHOR]

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PURPOSE: The study aims to investigate the direct and indirect relationships among market orientation, service program innovativeness, and the financial performance of hospitals. Two types of market orientation – responsive and proactive – were considered, along with two dimensions of service program innovativeness: meaningfulness and novelty. METHODOLOGY: The study gathered data through a survey conducted on a random sample of 204 Polish hospitals. Structural equation modeling was used to analyze the data, test a conceptual model designed as a parallel two-mediator model, and validate the hypotheses. FINDINGS: The work revealed both direct and indirect effects. In terms of direct effects, the study found that implementing a responsive market orientation positively influences the meaningfulness of a hospital’s service program but has no impact on its novelty. Conversely, the implementation of a proactive market orientation has a positive influence on both the meaningfulness and novelty of the program. Furthermore, the meaningfulness and novelty of the program contribute positively to the hospital’s financial performance. In terms of indirect effects, the study identified mediation phenomena: a responsive market orientation positively affects a hospital’s financial performance through the meaningfulness of the service program, while a proactive market orientation enhances financial performance through the novelty of the program. IMPLICATIONS: The study contributes to the current understanding, confirming the positive impact of a proactive market orientation on innovations within the organization while contradicting the view that a responsive market orientation supports these innovations. Additionally, the results support the idea that innovations within the organization have a positive impact on its outcomes. The study also reveals specific mechanisms that influence market orientation on organizational outcomes, indicating that a responsive orientation affects a service provider’s outcomes through the meaningfulness of its service program, while a proactive orientation influences outcomes through the novelty of the program. The practical recommendations for hospital managers are as follows: (a) to achieve a high level of meaningfulness in the service program, it is advisable to implement both responsive and proactive market orientations; (b) to attain a high level of novelty in the program, a proactive market orientation is recommended; (c) to enhance the hospital’s financial performance, it is suggested to develop a service program that is both meaningful and novel, and to implement both responsive and proactive market orientations. ORIGINALITY AND VALUE: The study’s originality and value stem from its exploration of specific direct and indirect mechanisms through which market orientation affects hospital financial performance, filling a prior research gap. By investigating these mechanisms, the study enhances the overall understanding of hospital management. [ABSTRACT FROM AUTHOR]

Purpose: The study aims to investigate the nurse job enjoyment and their participation in medical affairs to enchance the quality of patient care in Saudi hospitals. In addition, this study also investigates the management team's role in patient care quality through the mediating effects of nurse job enjoyment and participation in medical affairs. Design/methodology/approach: The present study used a self-administered survey questionnaire to collect data from registered nurses in Saudi hospitals. In this study, 600 survey questionnaires were distributed online (Google Forms) and received 266 valid responses (44.33% response rate). In addition, SmartPLS-4.0 was applied to validate the research constructs and test the hypotheses via partial least squares structural equation modelling (PLS-SEM). Findings: The study's findings indicate that the job enjoyment of the nurses and participation in medical affairs have positive and significant effects on the quality of patient care. In addition, the research findings also suggest that the management team of the hospitals has a significant indirect influence on the quality of patient care through the medicating effects of nurse job enjoyment and participation in medical affairs. Practical implications: The findings of this study also offer various practical implications. This study showed the direct impact of the management team on job enjoyment, medical affairs and patient care quality. Therefore, hospital authorities and policymakers may emphasise clear communication, collaboration, respect and trust for the effective management team in providing higher-quality patient care. The present study suggests that hospital policymakers should strive to create a positive work environment, provide adequate resources, foster team spirit, offer incentives and allow flexible scheduling to ensure higher job enjoyment and increase nurse participation in medical affairs. Originality/value: This study adds to the growing body of knowledge by investigating the effects of the management team, job enjoyment and nurses' participation in medical affairs on patient care quality. This study also enhances the theoretical depth by exploring the mediating impact of job enjoyment in predicting the relationships between the management team and the quality of care provided to patients. The present study provides guidelines for healthcare service providers or practitioners to focus on the nurses' job enjoyment and their engagement in medical activities to continuously improve the quality of patient care in the hospitals. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Economic Administrative & Legal Sciences is the property of Arab Journal of Sciences & Research Publishing (AJSRP) 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.)

Medical devices (MDs) play a critical role in healthcare delivery while also bringing potential medical risks and unintended harms to patients. Although government regulation is well recognized as a critical and essential function for ensuring the safety of MDs in many countries, the supplementary role that hospitals play is often neglected. This paper constructs a tripartite evolutionary game model involving the government, hospitals, and MDs enterprises to explore their strategic behaviors of MDs regulation in healthcare delivery. We performed theoretical analysis and numerical simulations to examine the stability of stakeholders' strategy selections. Our results reveal that: (1) Evolutionarily stable strategy (ESS) can be reached under specific revenue conditions for the government, hospitals, and MDs enterprises. (2) Penalty intensities largely affect the convergence rates of hospital strict management and enterprise quality improvement strategies. (3) Whistleblowing is an efficient factor to influence strategy selections of the hospital and MDs enterprise. Based on these findings, we propose policy recommendations to enhance MDs regulation effectiveness, including encouraging hospitals' engagement in regulation, promoting whistleblowing with more public participation, balancing penalty systems, and strengthening multi-party cooperation. [ABSTRACT FROM AUTHOR]

Many hospitals risk closure owing to rising costs, declining revenue, and reduced profits. Given the importance of identifying factors that impact hospital profitability, our study examines the relationship between tangible assets and the financial performance of hospitals in South Korea. We also investigate the moderation effects of hospital location. Our analysis is based on hospital accounting data provided by public institutions in South Korea and includes medical facilities, machine facilities, structures, buildings, and vehicle assets as tangible assets, which affect three types of return on assets. The results indicate that medical facilities and building assets have a significant positive impact on medical profits but a negative effect on income before reserve funds for essential business and net income, which can be offset by increased vehicle and transportation equipment assets. Operating vehicles and transportation are particularly beneficial for hospitals in Seoul metropolitan areas. This study is meaningful because it uses reliable, externally audited data from an advanced South Korean medical market. Our findings may provide valuable insights for policymakers and hospital management seeking to improve hospital profitability and identify institutions requiring financial assistance not only in South Korea but also in other countries that have advanced medical markets. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to evaluate repeated participation in hospital smoking cessation services and its related factors and to explore the correlation between the frequency of participation and its effectiveness in smoking cessation. This study uniquely follows participants over a seven-year period after the removal of financial barriers, with a maximum charge of TWD 200 (USD 6.4) for cessation medications in Taiwan. Methods: A secondary analysis of data from a regional teaching hospital in Central Taiwan was conducted, utilizing the database of the Smoking Cessation Therapy Management Center of Health Promotion Administration and the hospital's documentation from 2013 to 2019. Successful smoking cessation was defined as a non-smoking status at the six-month follow-up stages. Repeat participation was identified through the hospital's smoking cessation logs. Logistic and Cox regression analyses were conducted to meet the study objectives, with all statistical procedures performed on SAS version 9.4. Results: In this study, 19.16% of the smoking cessation service users participated repeatedly over a period of seven years. After adjusting for the observation time, the Cox regression analysis showed that those who experienced the side effects of smoking cessation, long-term smokers, and those with a history of disease were more likely to participate again (HR:1.39;1.17;2.60). However, those who smoked heavily, drank alcohol, and failed to quit smoking after previous participation were significantly less likely to participate again (HR:0.59,0.55,0.70;0.89;0.66). Finally, this study found no significant correlation between the frequency of repeated participation and the effectiveness of the last smoking cessation service. Conclusion: A certain proportion of smokers repeatedly participate in the same hospital's smoking cessation program, which does not diminish its effectiveness. It is implied that relaxing the limit on the quantity of smoking cessation services subsidies will contribute to overall tobacco harm control efforts. [ABSTRACT FROM AUTHOR]

Objective: Today, air medical services play a key part in providing emergency medical services in accidents and disasters in many countries, including Iran. The present study aims to investigate the barriers to air medical services in accidents and disasters in Iran and suggest solutions to them. Results: Analysis of the qualitative data resulted in extraction of 84 codes, which were classified into 13 subcategories and eventually into four themes, namely planning, management of resources, updating procedures, and empowerment of human resources. The findings also underscored the role of general policies, safety of flights and the scene of the accident, the cost and length of arriving at the scene of the accident, training programs designed to enhance the personnel's preparation, and management of disasters and accidents. Senior medical emergency services managers can use the findings of the present study to identify the challenges which pre-hospital emergency care personnel are faced to air medical services in accidents and disasters and take the necessary measures to eliminate them toward improving the quality of pre-hospital care in air medical services in accidents and disasters. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Background Design Methods Results Conclusions Implications for the Profession and/or Patient Care Impact Reporting Method Patient or Public Contribution To analyse the relationship between authentic nursing leadership and safety climates across hospital settings during the COVID‐19 pandemic.Authentic nursing leadership shapes the safety climate by fostering positive perceptions of workplace policies, processes, procedures and practices that influence how safety is prioritised and addressed within an organisation.A cross‐sectional study.Our study was conducted from December 2021 to December 2022 in six Brazilian hospitals. Participants were nursing staff working in General Medicine Units, Intensive Care Units (ICU) and Emergency Departments (ED) who provided care to patients with COVID‐19. The Authentic Leadership Questionnaire and the Safety Attitudes Questionnaire were used to measure nursing staff perceptions of authentic leadership and safety climates. Data were analysed using descriptive and inferential statistics.391 nursing staff across six hospitals participated. Self‐awareness significantly enhanced perceptions of the safety climates. Additionally, being a Registered Nurse and working in the ICU were positively associated with achieving safe climates in the working environment. In contrast, working in EDs was significantly negatively related to safety climates.The COVID‐19 pandemic underscored a lack of authentic nursing leadership and unsafe climates. Therefore, it is critical to implement educational strategies that foster authentic leadership, particularly focusing on self‐awareness, to promote more positive safety climates. Ensuring that leadership and safety climates are relationship‐focused is critical to enhancing patient outcomes.Nursing staff's perceptions of authentic leadership and safety climates are important in making more informed decisions about patient management.Since self‐awareness increases positive perceptions of safety climates, nursing staff should exercise it to guide their actions in facing future health crises.STROBE guidelines.Higher self‐awareness in relationships with others is a predictor of safety climates and can lead to enhanced patient outcomes. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion To audit adherence to the Swedish paediatric guidelines for urinary tract infections (UTIs) in infants. Secondary objectives were to compare findings on imaging performed according to the guidelines with imaging without guideline support and to identify predictors of non‐adherence.A prospective multicentre study of infants <1 year treated at paediatric hospitals for their first UTI. Adherence to recommendations was assessed for diagnosis, treatment, and imaging of the urinary tract with a follow‐up period of 1 year. Vesicoureteral reflux on voiding cystourethrography and findings on renal scintigraphy according to recommendations were compared to imaging without recommendation.A total of 1357 infants were included. Adherence to recommended diagnostic procedures, antibiotic treatment, and imaging was 86.1%, 91.0% and 64.2%, respectively. Non‐adherence to imaging recommendations was associated with inpatient management and smaller hospitals but was also more often due to excessive rather than refrained imaging.High adherence rates to diagnostic and treatment recommendations indicate careful attention to infant UTI among paediatricians. Lower adherence to imaging recommendations raises concerns regarding the guideline algorithm; particularly, early DMSA scans seem to be challenging for smaller hospitals. [ABSTRACT FROM AUTHOR]

The study published in the Arab Journal of Management examines the impact of the Big Five personality traits of physicians on job alienation, focusing on hospital doctors in the southern Palestinian governorates. The researcher used a proposed model and distributed questionnaires to 322 doctors, where the results showed a significant correlation between personal factors and job alienation. The researcher recommended that hospital management should pay attention to the personal factors of doctors to enhance the work environment and reduce job alienation. [Extracted from the article]

Background: Falls in hospitals continue to burden patients, staff, and health systems. Prevention approaches are varied, as well as their success at preventing falls. Intervention component analysis (ICA) is useful in indicating important features associated with successful interventions in sets of trial with high heterogeneity. Methods: We conducted an ICA of systematically identified randomised controlled trials of interventions for preventing falls in older people in hospitals. Trial characteristics were extracted; inductive thematic analysis of published papers from included trials to seek triallists perspectives on drivers of success or failure of trials was conducted (ICA stage one) followed by a stratified thematic synthesis by trial outcomes, where trials were classified as positive or negative based on their falls rate or falls risk ratios (ICA stage two) and mapped to the presence of the theorised drivers of success or failure of the trials. Results: 45 trials met the inclusion criteria. Inductive thematic analysis of 50 papers revealed three key drivers (themes), each with subthemes, of effective inpatient hospital fall prevention trials. Theme 1, integration with the local setting, was present in 79% of the positive trials and 67% of the negative trials (79% vs 62% engaging ward staff and 33% vs 43% engaging hospital management). Theme 2, responsive interventions, was present in 83% of the positive trials and 71% of the negative trials (29% vs 38% targeting patient risk assessments and 83% vs 57% tailoring to patient needs and abilities). Theme 3, patient and family involvement, featured in 83% of the positive trials and 52% of the negative trials (50% vs 19% through fall prevention awareness and 58% vs 48% through an active role in fall prevention). Conclusion: Tailored fall prevention approaches and involving patient and family in fall prevention through increasing awareness, in addition to integration with the local intervention setting, appear to play a role in impacting the effectiveness of fall prevention interventions. These theories should be considered in the design of future fall prevention programs and trials and require further evaluation in high quality trials. [ABSTRACT FROM AUTHOR]

Background and purpose: This study aims to examine the challenges within the management structures of public hospitals, particularly how these challenges impede the achievement of executive goals. If the consequences of these challenges are not adequately addressed, they may result in significant issues in the management of medical and hospital services. These issues could have a detrimental impact on various stakeholders, including patients, hospital staff, and administrators. Therefore, this research identifies the key administrative challenges faced by public hospitals from the perspective of multiple stakeholders and proposes potential solutions to improve hospital management and service delivery. Materials and methods: This mixed-method study (quantitative and qualitative) involved two primary groups: healthcare providers and hospital managers/senior professionals, including 14 senior staff from a public hospital. In the qualitative phase, semi-structured interviews were conducted to identify the challenges in public hospitals. In the quantitative phase, a questionnaire was developed based on the qualitative findings and the opinions of 363 experts. Exploratory factor analysis was performed using SPSS and AMOS software (version 24). Results: According to stakeholders, the challenges in managing public hospitals were identified across four key categories: financial, procedural and decision-making, human resources, and infrastructure. The results of the data analysis revealed that procedural and decision-making challenges had a coefficient of 0.89 with a significance level of 7.881; financial challenges had a coefficient of 0.79 with a significance level of 6.994; human resource challenges had a coefficient of 0.75 with a significance level of 6.641; and infrastructure challenges had a coefficient of 0.43 with a significance level of 3.807. Conclusion: The study results indicate that procedural and decision-making challenges in public hospitals are key factors significantly affecting the achievement of hospital operational goals and have a broad influence on other critical aspects of public hospital services, including patient satisfaction and service efficiency. Additionally, financial constraints, human resource limitations, and infrastructure challenges diminish hospitals' capacity to effectively meet patients' needs and organizational goals in both quantitative and qualitative terms, posing serious barriers to healthcare quality and accessibility. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the article is to assess selected aspects of the implementation of an electronic document management system, which is based on the presented case study. Concerning a review of the literature, key success factors in this area that were identified and analyzed based on a selected implementation project. Design/methodology/approach: The research was conducted by using a case study combined with the use of direct observation by the co-author of the article. The selection of a clinical hospital in the discussed scope allows for the formulation of appropriate final conclusions. Findings: The analysis of the case study allows for the formulation of conclusions regarding implementation projects in the field of electronic document management system in healthcare units. Research limitations/implications: Using a case study of one hospital confirms a limitation in the complete generalization of the final conclusions. Originality/value: The article indicates important aspects of conducting research in the field of management of IT project implementations in healthcare units. For practitioners associated with the healthcare sector, the article can be a reference point in searching for inspiration and good practices in the discussed research area. [ABSTRACT FROM AUTHOR]

Purpose: Despite the advent of New Public Management theories over three decades ago, doubts persist regarding the practical implementation of these principles in the public health-care context. Challenges arise particularly from the type of system where this phenomenon is analyzed. In the Italian context, for instance, it can be arduous to define universally applicable organizational behaviors, given the interregional disparity that characterizes such a system. Furthermore, the professional identity of clinician-managers influences the perception of what "being a manager" means. This paper, thus, using the Italian context as a reference, aims to delineate what is the perception of Italian public hospitals clinician-middle-managers in terms of their responsibilities and tasks. Design/methodology/approach: A survey-questionnaire was distributed to 6,011 Chief Medical Officers (CMOs) in Italian public hospitals, representing 100% of such role holders in the country. With a response rate of 16.7%, 1,005 responses were obtained. The questionnaire assessed CMOs' attitudes toward specific activities relevant to clinician-management, ranked from most to least important. Activities were derived from literature and categorized to discern management styles. Subgroups based on geographical location and professional orientation were also identified to isolate regional effects and professional identity influences. Findings: Results suggested that activities associated with a collaborative approach are perceived as most important. Furthermore, it clearly emerges the difference based on professional orientation of CMOs. However, it could not be appreciated the same level of difference basing the analysis on regional disparities. Originality/value: The interest in the role of middle management in healthcare organizations has increased over the years. Nevertheless, currently the authors believe that not many studies are focused on defining what "being a manager" means for clinician-managers themselves, rather than explaining what clinician-managers shall do. [ABSTRACT FROM AUTHOR]

The management of paracetamol poisoning in our local health network and consistency with national guidelines is unclear. We conducted a 4‐month retrospective study of all paracetamol poisonings identified in two South Australian hospitals. Most presentations were deliberate self‐poisoning (90.7%) with immediate‐release formulations (88.0%). Although most were managed in accordance with national guidelines, there were deficiencies in documentation of the poisoning details and patient weight as well as cases of underdosing of the antidote. Quality improvement initiatives are needed. [ABSTRACT FROM AUTHOR]

Background: The global public health burden of rare diseases has become an increasingly discussed topic, and its societal impact cannot be overstated. While it may seem counterintuitive to discuss broad healthcare and public health impact in the context of rarity, taken together, over 400 million people worldwide are estimated to live with a rare disease. Over half of people living with a rare disease are children. Providing robust and comprehensive services to the rare disease community requires coordinated efforts of numerous experts and partners. Globally, there are many initiatives focused on improving the lives of people living with a rare disease. Most of these networks and organizations are region or country based and have historically centered on three focal areas: research; provision of education, support, and/or information; and direct clinical care. While all these efforts recognize the importance of a coordinated system of partners across a spectrum of disciplines to improve care for the rare disease community, one group has been largely untapped: hospital administrators and leadership. To address this gap, the International Hospital Federation (IHF) convened the Global Rare Pediatric Disease Network (GRPDN), composed of hospital leaders from around the world. To assess how hospital leadership can assist in providing the infrastructure for improving care for patients and families living with a rare disease, the GRPDN created a survey to gather feedback on hospital administrators’ perspectives on needed efforts to improve global rare disease care. Results: The survey identified five themes: increased public awareness of rare diseases and support for families, diagnostic management and treatment guidelines, lifelong, multidisciplinary care, data and research, and funding. Conclusions: Until recently, hospital leadership has been an untapped partner in addressing challenges faced by rare disease patients, and they are uniquely positioned to bridge existing gaps. The GRPDN will continue to focus on identifying practical strategies that hospital leaders—regardless of resource level—can implement to improve care for children living with a rare disease. [ABSTRACT FROM AUTHOR]

Background: Peutz-Jeghers Syndrome (PJS) is a rare hereditary polyposis syndrome that is autosomal dominant and has the main characteristics of hamartoma polyps, mucocutaneous pigmentation, and increased susceptibility to malignancy. Case: This case report presented a 19-year-old man referred from a secondary hospital with complaints of diarrhea for one month before hospital administration. The symptoms happened five times a day with residue in the stool. Mucus or bleeding was not found. Around ten days prior, the polyp came out from the anus, but the patient could pull it back by himself. Diarrhea had been recurring since 2014. The patient then underwent polypectomy (while still children) and until now has undergone polypectomy 11 times. Abdominal CT scan showed multiple polyps with varying morphology in the luminal mucosa of the duodenum, jejunum, ileum, descending colon, sigmoid colon, and rectum, in accordance with the presentation of Peutz-Jeghers syndrome. The colonoscopy examination found a Peutz-Jeghers appearance after a polypectomy with a hemoclip installed. The patient was diagnosed with Peutz-Jeghers Syndrome post polypectomy. The patient received a plan for postoperative complete blood count examinations and periodic colonoscopies. Conclusion: PJS is an important diagnosis to consider in young patient with polyposis, even without mucocutaneous pigmentation. [ABSTRACT FROM AUTHOR]

At the latest since the Medical Services Healthcare Insurance Reform Act (MDK), the declared will of the legislation is the conversion of operations previously carried out in an inpatient setting to an outpatient setting. In trauma surgery and orthopedics numerous operations are carried out that could principally also be performed in an outpatient setting; however, a prerequisite is a medical assessment of the suitability of patients as well as an economic and normative framework that makes outpatient surgery attractive. Both the Outpatient Surgery in Hospitals Catalogue (AOP-Katalog) and the first edition of the Hybrid Diagnosis-related Groups (DRG) define interventions in trauma surgery that could be carried out in an outpatient setting. Hospitals are therefore required to find solutions for these interventions under processual and economic provisos. These range from omission of outpatient operations to the expansion as a separate financial department in the hospital. With the introduction of the hybrid DRG, the legislation enables equal remuneration for outpatient versus short-term inpatient treatment and leaves the case management up to the hospital; however, the performance of the AOP in the setting of a hospital and also hybrid case flat rates are as a rule not economically viable and bear the risk of the failure of all efforts at conversion to outpatient settings. It is necessary to carry out a fundamental revision of the remuneration and framework conditions for outpatient operations in trauma surgery and orthopedics in hospitals, involving practitioners. This is the only way that the conversion to outpatient treatment can succeed. [ABSTRACT FROM AUTHOR]

Subjective factors of music have been proven to significantly influence the effect of music masking, while the neural mechanism of music masking is unknown. This study aims to explore the neural mechanism by which music masking improves subjective perception of noise in the population. A total of 40 healthy subjects were recruited for both the subjective evaluation and functional near-infrared spectroscopy scanning during music masking of hospital noise. Annoyance reduction percentage (ARP), likability, familiarity, and brain response data were collected and analyzed. The results showed that the increasing of ARP and likability was significantly correlated with the activation of the bilateral dorsal–lateral superior frontal gyrus (DLPFC) and the orbital middle frontal gyrus (OFC), while the improvement of familiarity significantly activated the triangular inferior frontal gyrus, supramarginal gyrus, and middle temporal gyrus. The repeatedly activated channels located in DLPFC and OFC indicate that likability may play a key role in reducing annoyance through music masking. This study provides a scientific basis for the selection of masking music future noise management in hospitals. [ABSTRACT FROM AUTHOR]

Continuous glucose monitoring (CGM) systems provide frequent glucose measurements in interstitial fluid and have been used widely in ambulatory settings for diabetes management. During the coronavirus disease 2019 (COVID-19) pandemic, regulators in the U.S. and Canada temporarily allowed for CGM systems to be used in hospitals with the aim of reducing health care professional COVID-19 exposure and limiting use of personal protective equipment. As such, studies on hospital CGM system use have been possible. With improved sensor accuracy, there is increased interest in CGM usage for diabetes management in hospitals. Laboratorians and health care professionals must determine how to integrate CGM usage into practice. The aim of this consensus guidance document is to provide an update on the application of CGM systems in hospital, with insights and opinions from laboratory medicine, endocrinology, and nursing. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to analyze treatment outcomes and their predictors in children hospitalized due to varicella complicated by bacterial superinfections after pandemic of COVID-19. Methods: This retrospective study analyzed data collected in a multicenter, nationwide, observational database dedicated for children aged 0–17 years hospitalized due to bacterial complications of varicella in 9 Polish tertiary healthcare inpatient centers. The primary endpoint of this study was the treatment outcome established after the end of hospital management assessed at a 4-point scale. The secondary endpoint was defined as the necessity of surgical intervention. Results: There were 458 patients with a median age of 4 (IQR 2–6) years. After the completed treatment, 319 (69%) participants were found fully recovered; 132 (29%) had transient complications; 2 (0.5%) had persistent complications; and 1 child (0.5%) died. Multivariate analysis revealed that implementation of ibuprofen in pre-treatment management of a child with varicella was associated with a 4.07-fold (2.50–6.60) increase in risk of complications after the treatment and it was associated with 2.87 times (1.39–5.89) higher risk of surgical intervention necessity. For other pre-hospital interventions (implementation of acyclovir, antibiotics or antihistaminics) no significant impact was observed. GAS infection increased the necessity of surgical intervention by 7.51 (3.64–15.49) times. Conclusions: One-third of patients treated for bacterial complications of varicella have post-treatment complications, most of them transient. GAS infection increases the need for surgical intervention. The use of ibuprofen in the treatment of varicella significantly increases the risk of complications and the need for surgical intervention. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) has emerged as a transformative force in enhancing patient safety within hospital settings. This perspective explores the various applications of AI in improving patient outcomes, including early warning systems, predictive analytics, process automation, and personalized treatment. We also highlight the economic benefits associated with AI implementation, such as cost savings through reduced adverse events and improved operational efficiency. Moreover, the perspective addresses how AI can enhance pharmacological treatments, optimize diagnostic testing, and mitigate hospital-acquired infections. Despite the promising advancements, challenges related to data quality, ethical concerns, and clinical integration remain. Future research directions are proposed to address these challenges and harness the full potential of AI in healthcare. [ABSTRACT FROM AUTHOR]

Background: A small number of post-cholecystectomy syndrome cases result from residual stones in a lengthy cystic duct or recurrence of lithiasis in a remaining gallbladder (GB) tissue. In laparoscopic procedures, up to 13.3% may involve incomplete GB removal due to surgical complexities and anatomical variations such as adhesions or challenging morphology. Aims and Objectives: (1) To assess the incidence of retained stones in patients undergoing cholecystectomy, (2) to compare incidences among open and laparoscopic cholecystectomies, (3) to study various presenting ways and different investigational methods helping in early diagnosis and proper management, and (4) to study different operative interventions for different cases. Materials and Methods: This was a prospective and retrospective observational study. After getting ethical committee approval and informed consent, 35 patients were included in the study. The study was carried out in the Department of General Surgery at I.P.G.M.E.R./S.S.K.M. Hospital, Kolkata. Results: Most patients were post-open cholecystectomy cases. The incidence of retained GB stones was 4.48%, with females affected 2.8 times more than males. Common symptoms were pain abdomen (80%) and fever (25%). Ultrasonography diagnosed stump calculi in 85.71% of cases; magnetic resonance cholangiopancreatography (MRCP) was preferred when ultrasound was inconclusive. Conclusion: Cases underwent subtotal cholecystectomy or had long cystic duct stumps in rural hospitals, referred to tertiary hospital for further management. Symptoms included pain abdomen, fever, and sometimes jaundice. MRCP confirmed diagnoses before open re-exploration; completion cholecystectomy addressed residual stones for symptom relief and cure. [ABSTRACT FROM AUTHOR]

Patient safety incident (PSI) reporting is essential to identify underlying problems and improve safety, but PSI reporting in Indonesian hospitals is still low. This study examines factors that contribute to PSI reports. It employed a cross-sectional design and analyzed data from Indonesia's 2019 Health Facilities Research. Methods: According to the criteria, the sample consisted of 462 hospitals. We evaluate the data using the chi-square test. The independent variables were documents, including strategic plans and hospital bylaws; activities included implementing a quality control system, monitoring and evaluation, internal audits, service evaluation and quality control, and periodic meetings. Results: Even though most hospitals already have documents and carry out activities, reports regarding PSI are still lacking in the surveyed hospitals, with half not having any. In Indonesian hospitals, all variables were significantly associated with PSI reports. Hospitals with these documents and management activities, like strategic plans, internal audits, or evaluations, have more PSI reports. Conclusion: The number of PSI reports has increased due to changes in reporting culture, which may indicate a safer culture rather than necessarily an increasing risk. Adopt a comprehensive, data-driven strategy, concentrating on incident reporting and detection. Hospital management must sustainably monitor, assess, and evaluate to encourage PSI reporting. [ABSTRACT FROM AUTHOR]

Purpose: Surgical trainees are at high risk of burnout and poor wellbeing during their training. A range of workplace factors have been linked to poor wellbeing, including excessive work hours, lack of support networks, and training program demands. However, little is understood about the individual experiences of Australian trainees and their perceptions of the impact of the work environment on wellbeing. The aim of this study was to explore the experiences of Australian surgical trainees regarding their wellbeing in the surgical learning environment. Methods: Eleven semi-structured interviews were conducted with Australian surgical trainees at the start of their training and 18 months later, exploring their perspectives of wellbeing in the workplace. Results were analyzed thematically using the Job Demands-Resources model as a scaffold. Results: Seven themes emerged: (1) relationships with colleagues, (2) work hours and workload, (3) the learning environment and supervision, (4) training program requirements, (5) moving around, (6) hospital and team administration, and (7) hospital facilities and programs. Participant experiences between training commencement and 18 months follow-up did not change. Conclusion: Trainees have unique experiences of wellbeing in the workplace. Some workplace factors, such as relationships with colleagues, can be demands or resources depending on their nature. Effective leadership and administrative practices, mentorship, and proactive rostering act as resources for trainees to balance workplace demands, and these should be prioritized by hospitals and training institutions to improve and protect trainee wellbeing. [ABSTRACT FROM AUTHOR]

The article "Clinical governance in intensive care medicine" emphasizes the importance of patient safety in intensive care units (ICUs) and introduces the concept of clinical governance (CG) as a means to ensure safe, effective, and compassionate care. CG involves components such as systems awareness, teamwork, communication, ownership, and leadership, which are essential for quality improvement. Practical applications of CG in ICUs include patient and family-centered care, effective teamwork and communication, staff management and well-being, checklists, auditing, benchmarking, incident reporting, morbidity and mortality conferences, and multidisciplinary simulation. By utilizing these tools, ICUs can enhance patient outcomes and promote a culture of transparency, accountability, and collective learning. [Extracted from the article]

Objective: To determine user satisfaction of clinical faculty using Electronic Hospital Management Information System (eHMIS) in Lady Reading Hospital Peshawar Pakistan. Methods: This descriptive cross-sectional study was conducted in Orthopaedic Division Lady Reading Hospital Peshawar Pakistan from 15th March 2023 to 15th November 2023.All consultants serving in hospital fulfilling the inclusion criteria and consenting were included in this study. A validated questionnaire assessing the End User Computing Satisfaction (EUCS) was emailed to the included faculty. This questionnaire had 12 questions with answers ranked on the Likert scale (1 to 5 with 1 denoting almost never and five almost always). Data was analyzed with SPSS version 27. Results: We received 142 filled questionnaires. The mean age of our study participants was 43±2.1 years. Male participants were 128(90.14%) and female 14(9.85%). The eHMIS provided precise information to 112(78.87%) consultants most of the time. Majority (91.54%, n=130) of the respondents agreed that the information content met their need most of the time. Many (57.04%, n=81) consultants admitted that the output was presented in useful format most of the time and the information of was clear most of the time to 117(82.39%) consultants. Majority (69.71%, n=99) of the respondents got the information they needed in time almost always. The eHMIS provided up-to-date information almost always to 111(78.16%) respondents. Conclusion: Majority of our consultants were satisfied with the Electronic Hospital Management Information System (eHMIS) most of the time to almost always and most were using it several times daily. [ABSTRACT FROM AUTHOR]

Enterprise resource planning (ERP) is an integrated system for managing the administrative, financial and medical aspects of hospitals and health care institutions. The system aims to organize the work in the hospital to allow access to the patient’s data and follow-up while he is in the hospital, to organize the provision of service to the patient in an optimal manner and in the fastest time, to organize appropriate treatment programs for each case, and to facilitate the doctor’s work through medical registration of the patient’s condition (complaints and symptoms - examinations, analyzes and radiology - Operations - Diagnostics - Doctors’ orders and follow-up on their implementation - Follow up the progress of the patient’s condition - Medications and medical recommendations), which facilitates the follow-up of the patient’s health development and ensures accuracy and speed of performance.. Problem of the project: What is the level of knowledge of health personnel about ERP? What is the relationship between demographic variables and health personnel’s knowledge of ERP? Objective: the study aims to increase revenue, improve performance, reduce risk, providing a classification of the ERP integration concept in a healthcare Organization. Methodology: This study included a sample of health staff members numbering (71), and the study uses a questionnaire that includes (24) items to verify the sample's knowledge about the enterprise resource planning system. For the purpose of data analysis, the arithmetic mean, standard deviation, percentage, and a sample dependent test were Chi-square. the majority of health cadres (59.2%) are female, and with regard to the educational level, the majority (35.2%) of the sample was (diploma). Years of service The majority (35.2%) of the sample (10-6) years. Regarding the housing environment, the majority were city dwellers. Table (4-2) indicates that health personnel have good knowledge of general information about the enterprise resource planning system. Table (3-6) indicates that there is no relationship between the knowledge of health staff members and demographic information about the ERP system and the impact of this. The study shows that percentage of successful knowledge about ERP is 77.5% while the proportion of Poor knowledge 21.1%. [ABSTRACT FROM AUTHOR]

Efficient management of hospital evacuations and pharmaceutical supply chains is a critical challenge in modern healthcare, particularly during emergencies. This study addresses these challenges by proposing a novel bi-objective optimization framework. The model integrates a Mixed-Integer Linear Programming (MILP) approach with advanced machine learning techniques to simultaneously minimize total costs and maximize patient satisfaction. A key contribution is the incorporation of a Gated Recurrent Unit (GRU) neural network for accurate drug demand forecasting, enabling dynamic resource allocation in crisis scenarios. The model also accounts for two distinct patient destinations—receiving hospitals and temporary care centers (TCCs)—and includes a specialized pharmaceutical supply chain to prevent medicine shortages. To enhance system robustness, probabilistic demand patterns and disruption risks are considered, ensuring supply chain reliability. The solution methodology combines the Grasshopper Optimization Algorithm (GOA) and the ɛ-constraint method, efficiently addressing the multi-objective nature of the problem. Results demonstrate significant improvements in cost reduction, resource allocation, and service levels, highlighting the model's practical applicability in real-world scenarios. This research provides valuable insights for optimizing healthcare logistics during critical events, contributing to both operational efficiency and patient welfare. [ABSTRACT FROM AUTHOR]

This study investigates The Medical Record Department (MRD) plays a pivotal role in the hospital administration framework at Shri Balaji Hospital, ensuring the efficient management and organization of patient health data. As an essential component of healthcare delivery, the MRD is responsible for maintaining accurate, comprehensive, and up-to-date records for all patients treated at the facility. This includes not only clinical data such as diagnosis, treatment plans, and surgical histories, but also administrative information vital for billing, insurance, and regulatory compliance. At Shri Balaji Hospital, the MRD operates under strict protocols to guarantee the confidentiality and security of patient records in accordance with legal and ethical standards. The department is crucial for the coordination of multidisciplinary care, as it facilitates the timely and accurate sharing of medical information between healthcare professionals, thus ensuring continuity of care and improving patient outcomes. The MRD also plays a significant role in hospital operations by supporting functions such as audits, quality control, and risk management. It ensures that the hospital adheres to national healthcare standards, including those set by accrediting bodies and government regulations. In this regard, the department's meticulous record-keeping supports the hospital's efforts in continuous quality improvement and patient safety initiatives. [ABSTRACT FROM AUTHOR]

Background and Aim: A global increase in nonalcoholic fatty liver disease (NAFLD) prevalence has been observed in the last decade. This study assesses knowledge, awareness, and clinical practice gaps of hepatologists and non‐hepatologists in NAFLD management across hospitals in China. Methods: A web‐based quantitative survey was conducted, and participants included hepatologists (gastroenterologists and infectious disease specialists) and non‐hepatologists (internal medicine specialists, cardiologists, and pharmacists) from various hospitals across China. Results: In total, 1627 healthcare practitioners (HCPs) responded to the survey. This included 658 hepatologists and 969 non‐hepatologists. In comparison to 92.6% hepatologists, only 58.0% of non‐hepatologists were aware of NAFLD. A higher proportion of hepatologists (82.8%) performed screening for NAFLD compared to non‐hepatologists (56.9%). Majority of the hepatologists (70%) and non‐hepatologists (67%) were aware of the four primary recommendations for managing NAFLD. Only 11% of hepatologists did not manage NAFLD patients, mainly because they felt they did not have enough time (66.7%). Of the 36% non‐hepatologists who did not manage NAFLD, 78.4% stated that NAFLD is not their specialty, and 38.6% were not familiar with the treatment options. Conclusion: Most hepatologists were aware of and agreed to performing screening for NAFLD compared to non‐hepatologists. Both hepatologists and non‐hepatologists exhibited similar level of understanding on NAFLD management. However, a small percentage of both hepatologists and non‐hepatologists admitted that they did not manage NAFLD patients because they were not familiar with available treatment options. This underscores the importance of further educating HCPs involved in managing NAFLD. [ABSTRACT FROM AUTHOR]