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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]

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Background and Aim: The impact of hospital management on COVID-19 mortality involves examining various management strategies, assessing the adequacy of hospital resources, and evaluating the efficiency of healthcare systems in response to the COVID-19 pandemic. Evidence suggests that effective hospital management and adequate hospital equipment can significantly reduce COVID-19 mortality rates. However, evidence regarding the role of these factors in military hospitals in Iran is limited. The present study aims to investigate the effect of human resource management and hospital equipment in COVID-19 related mortality in five military hospitals in Iran. Methods: Hospital data, including the number of hospital beds, number of nurses, number of ICU beds, number of ICU nurses, number of hospital ventilators, availability of CT scan or PCR devices, and hospital infection rates, were collected from the specified hospitals in Tehran, Tabriz, Kerman, Isfahan, and Kermanshah during the period from February 2021 to July 2022. Data collection was done through in-person and interview methods. Results: The study analyzed data from the records of 2,500 patients who died from COVID-19 in five medical centers in Tehran, Tabriz, Isfahan, Kerman, and Kermanshah. Factors such as the percentage of ICU beds relative to the total number of hospital beds, the percentage of ICU nurses relative to the total number of hospital nurses, and the percentage of ICU beds relative to the total number of hospital admissions showed an inverse relationship with COVID-19 mortality, although this relationship was not statistically significant. The most significant factor associated with mortality was an increase in the number of occupied hospital beds. Conclusion: Military hospitals in Iran have been relatively successful in controlling the COVID-19 epidemic, and human resource management and hospital equipment do not have a significant correlation with high mortality rates. However, a high number of patient admissions in the context of insufficient resources can affect COVID-19 mortality. Increasing the number of treatment-related equipment, such as ventilators, and optimizing ICU can improve hospitals' ability to combat against COVID-19, thereby helping to reduce mortality rates. [ABSTRACT FROM AUTHOR]

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

The use of catheters is very common in clinical care and is a highly invasive procedure, and catheter-associated urinary tract infection (CAUTI) is an important cause of hospital-acquired infections. CAUTI is a serious complication caused by catheter insertion, usually within 48 hours of catheterization or after removal of the catheter. This article reviews the nursing measures for the prevention of CAUTI in perspectives of influencing factors, selection of catheter, catheter placement and catheter maintenance, aiming to promote the development of long-term indwelling catheter technology and provide reference for prevention and treatment of CAUTI in clinical practice. (导管相关性尿路感染(CAUTI)是医院内感染最常见的类型之一。CAUTI是一种由插入尿管引起的严重的并发症, 通常出现在患者接受插管治疗后的48 h内或者在取出导尿管之后。本本研究就引发CAUTI的主要影响因素、导尿管的选取、导管的留置操作、管路维护以及医院管理等方面进行综述, 旨在为防治CAUTI提供可靠参考。)

Management of medical centers operates in a difficult environment in which limited medical resources must be used effectively and efficiently while paying attention to medical policies and trends of patients. Many medical centers struggle with these issues. Japanese Red Cross Tokushima Hospital provides medical services to a large number of patients in need of treatment by achieving short hospitalization stays and admitting new inpatients. Internal marketing that motivates staff to be patient-oriented and a service environment (artifacts, systems, structure, etc.) are used such that service processes can be implemented effectively and efficiently. Internal marketing is not limited to “inside” the hospital, but is extended to “outside” the hospital, such as local medical centers, ambulance teams, and patients as customers. In addition to improvement of services within the hospital, this approach improves services through regional cooperation. The case of Japanese Red Cross Tokushima Hospital has important implications for the medical industry and for other industries.

To alleviate the medical burden of lung cancer surgery and facilitate the implementation of the national hierarchical diagnosis and treatment policy, it is imperative to establish a hierarchical diagnosis and treatment system for day surgery of lung cancer. Identifying key quality control checkpoints in day surgery of lung cancer is essential to enhance medical quality, ensure safety, and improve the efficiency of medical services. These efforts aim to uphold a safe and well-structured progression of day surgery practices in China. The Chinese Expert Consensus Group on Day Surgery Management of Lung Cancer has convened national experts in relevant fields and integrated the latest research findings from both domestic and international sources to craft the Chinese Expert Consensus on Day Surgery Management of Lung Cancer (2024 Edition). This consensus is founded on the principles of holistic management of lung cancer surgery and comprehensive patient care throughout their medical journey. It encompasses preoperative assessments, anesthesia protocols, surgical procedures, postoperative care, hospital-community collaboration initiatives, and emergency response strategies. The primary objective of this expert consensus is to furnish research assistance and clinical recommendations to advance the practice of day surgery for lung cancer patients in China.

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]

Copyright of Quarterly Journal of Marketing is the property of Japan Marketing Academy 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 alleviate the medical burden of lung cancer surgery and facilitate the implementation of the national hierarchical diagnosis and treatment policy, it is imperative to establish a hierarchical diagnosis and treatment system for day surgery of lung cancer. Identifying key quality control checkpoints in day surgery of lung cancer is essential to enhance medical quality, ensure safety, and improve the efficiency of medical services. These efforts aim to uphold a safe and well-structured progression of day surgery practices in China. The Chinese Expert Consensus Group on Day Surgery Management of Lung Cancer has convened national experts in relevant fields and integrated the latest research findings from both domestic and international sources to craft the Chinese Expert Consensus on Day Surgery Management of Lung Cancer (2024 Edition). This consensus is founded on the principles of holistic management of lung cancer surgery and comprehensive patient care throughout their medical journey. It encompasses preoperative assessments, anesthesia protocols, surgical procedures, postoperative care, hospital- community collaboration initiatives, and emergency response strategies. The primary objective of this expert consensus is to furnish research assistance and clinical recommendations to advance the practice of day surgery for lung cancer patients in China. [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.

【Background】 No detailed data regarding the duties performed by administrative staff at disaster-based hospitals during a disaster was found. 【Purpose】 The purpose of this study was to identify the duties performed by administrative staff at disaster-based hospitals during the Great East Japan Earthquake. 【Method】 A cross-sectional study using questionnaires and interviews was conducted. 【Target】 The target population was administrative staff at disaster-based hospitals in Iwate, Miyagi, and Fukushima prefectures. 【Result】 The study found that administrative staff were involved in 65 disaster operations that they would not normally perform. Normal operations were reduced to approximately 30% of their total capacity and were restored gradually. 【Consideration】 These 65 tasks included those that could be handled with external resources, those that required planning, and those that required training. Additionally, the study identified some normal operations that cannot be interrupted, such as management and labor management, highlighting the importance of planning. 【Conclusion】 To prepare for future disasters, it is necessary to develop educational programs and provide opportunities for administrative staff to learn how to perform their normal duties during disasters and to handle new tasks that may arise. In addition to using the results of this survey as the basic data for a realistic and effective revision of the BCP, the study emphasizes the need for disaster-based hospitals to have trained administrative staff who can perform a wide range of tasks during a disaster [ABSTRACT FROM AUTHOR]

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]