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The information used in the case study was obtained from secondary sources, such as internal documents, reports, news, and organization websites. Three of the four authors played a hands-on role in the case.

The COVID-19 pandemic exacerbated the global challenge of hiring and retaining health-care workers. To address its own challenges, Mayo Clinic decided to fundamentally transform its 30-year-old tuition assistance program: from a model centered on the premise that tuition assistance was an employee benefit for professional development purposes, to one that was more driven to meet the business needs of the employer by preparing internal talent for important roles throughout the institution. Herein, this case study first describes how the COVID-19 pandemic impacted health-care organizations like Mayo Clinic. Next, this study provides details on the original employee tuition assistance program, and then, focuses on the reasons for its need to be changed. Afterward, this study introduces the new tuition assistance programs. Finally, this study follows with examples of how both Mayo Clinic and its employees navigated through initial challenges, such as resistance to change and lack of engagement. In sum, this case study provides critical insight into designing workforce education programs that provide professional development for meeting the workforce needs of the organization.

This case can be used as teaching material in relevant undergraduate- and MBA-level courses, such as human resource management, human resource development and compensation and benefits. This case allows students to critically analyze workforce education programs (e.g. tuition assistance programs) and to plan how to strategically align those with the workforce needs of the organization.

Research has examined how new ventures strengthen local economic outcomes; however, limited research examines health-oriented ventures and their impact on social outcomes, including health outcomes. Increased VC investment in healthcare service start-ups signals more activity toward this end, and the need for further academic inquiry. We examine the relationship between these start-ups and county-level health outcomes, health factors, and hospital utilization.

Data on start-ups funded via institutional venture capital from PitchBook were merged with US county-level outcomes from the County Health Rankings and Area Health Resources Files for 2010 to 2019. We investigated how the number of VC-funded healthcare service start-ups, as well as a subset defined as innovative, were associated with county-level health measures. We used panel models with two-way fixed effects and Propensity Score Matched (PSM), controlling for demographics and socioeconomic factors.

Each additional VC-funded healthcare service start-up was related to a significant 0.01 percentage point decrease in diabetes prevalence (p < 0.01), a decrease of 1.54 HIV cases per 100,000 population (p < 0.1), a 0.02 percentage point decrease in obesity rates (p < 0.01), and a 0.03 percentage point decrease in binge drinking (p < 0.01). VC-funded healthcare service start-ups were not related to hospital utilization.

This work expands our understanding of how industry-specific start-ups, in this case healthcare start-ups, relate to positive social outcomes. The results underscore the importance of evidence-based evaluation, the need for expanded outcome measures for VC investment, and the possibilities for integration of healthcare services and entrepreneurship ecosystems.

Business models (BMs) are becoming increasingly crucial for value creation in the healthcare sector. The study explores the conceptualization and application of BM concepts within the healthcare sector and investigates their evolution in emerging economies (EEs) and developed economies (DEs). This study aims to uncover these two contexts' shared characteristics and unique variances through a comparative analysis.

The paper systematically investigates and consolidates the literature on healthcare by employing the antecedents, decisions and outcomes (ADO) framework and finally examines 71 shortlisted articles published between 2003 and 2022.

The recognition of the BM within healthcare is increasing, both in EEs and DEs. EEs prioritize value creation and capture through cost efficiency, while DEs focus on innovation. Key theories employed include a resource-based view, the network theory and the theory of innovation. Case studies are commonly used as a methodology. Further research is needed to explore the decisions and outcomes of BMs.

The study adopts stringent filtration and keyword criteria, potentially excluding relevant research. Future researchers are encouraged to broaden their selection criteria to encompass a more extensive range of relevant studies.

Beyond comparing and highlighting gaps in BMs between EEs and DEs, benchmarking DE's healthcare business models (HBMs) helps healthcare organizations in EEs align their practices, mitigate risks and establish efficient healthcare systems tailored to their specific contexts. The study adopts stringent filtration and keyword criteria, potentially excluding relevant research. Future researchers are encouraged to broaden their selection criteria to encompass a more extensive range of relevant studies.

The study analyzes HBMs using an SLR framework perspective and provides practical implications for academicians and practitioners to enhance their decision-making.

The migration of physicians is a global interest, causing imbalances between developed and developing countries. Romania is one of Europe's major providers of physicians, not because there is a surplus, but because physicians are drawn to places with better living and working conditions. Medicine in Romania is increasingly highly advanced, and Romanian physicians are well appreciated all over the world. Despite being one of the countries with the most medical graduates in the world, Romania is suffering a doctor exodus. After joining the EU, the problem of physician migration became widespread, resulting in a deficient and inefficient healthcare system. Therefore, the purpose of this study is to estimate the losses registered by Romania because of physicians' decision to migrate.

These losses were calculated in two ways: utilizing the statistical life value and the amount of money invested in training a medical graduate.

According to the findings, the losses in 2018 were 104.16 million euros, approximately 0.12% of GDP.

The originality of this paper consists in data, being provided by the College of Physicians from Romania and the method used, this study being the only one that estimates the cost of Romanian physicians' migration. The paper adds to existing knowledge an empirical results regarding quantifying the value reflecting the departure of physicians, using value of statistical life and the amount of money invested in preparing a medical graduate.

During the 1990s, Italian healthcare organisations (HOs) underwent a process of corporatisation, and the most innovative HOs introduced the balanced scorecard (BSC) to address the need for broader accountability. Currently, there is a limited understanding of the dynamics and outcomes of such a process. Therefore, this study aims to explore whether the BSC is still considered an effective performance management tool and analyse the factors driving and hindering its evolution and endurance in public and non-profit HOs.

We conducted a retrospective longitudinal analysis of two pioneering cases in the adoption of the BSC: one in a public hospital and the other in a non-profit hospital. Data collection relied on accessing institutional documents and reports from the early 2000s to the present, as well as conducting semi-structured interviews with the internal sponsors of the BSC.

We found evidence of three main categories of factors that trigger or hinder the adoption and development of the BSC: (1) the role of the internal sponsor and professionals’ commitment; (2) information technology and the controller’s technological skills; and (3) the relationship between the management and professionalism logics during the implementation process. At the same time, there is no evidence to suggest that specific technical features of the BSC influence its endurance.

The paper contributes to the debate on the key factors for implementing and sustaining multidimensional control systems in professional organisations. It emphasises the importance of knowledge-based assets and distinctive internal capabilities for the success of the business. The implications of the BSC legacy are discussed, along with future developments of multidimensional control tools aimed at supporting strategy execution.

Innovation management in the healthcare sector has undergone significant evolutions over the last decades. These evolutions have been investigated from a variety of perspectives: clusters, ecosystems of innovation, digital ecosystems and regional ecosystems, but the dynamics of networks have seldom been analyzed under the lenses of entrepreneurial ecosystems (EEs). As identified by Cao and Shi (2020), the literature is silent about the organization of resource allocation systems for network orchestration in EEs. This article investigates these elements in the healthcare sector. It discusses the strategic role played by entrepreneurial support organizations (ESOs) in resource allocation and elaborates on the distinction between sponsored and nonsponsored ESOs in EEs. ESOs are active in network orchestration. The literature explains that ESOs lift organizational, institutional and cultural barriers, and support entrepreneurs' access to cognitive and technological resources. However, allocation models are not yet discussed. Therefore, our research questions are as follows: What is the resource allocation model in healthcare-related EEs? What is the role played by sponsored and nonsponsored ESOs as regards resource allocation to support the emergence and development of EEs in the healthcare sector?

The article offers an explanatory, exploratory, and theory-building investigation. The research design offers an abductive research protocol and multi-level analysis of seven (sponsored and nonsponsored) ESOs active in French healthcare ecosystems. Field research elaborates on semi-structured interviews collected between 2016 and 2022.

This article shows explicit complementarities between top-down and bottom-up resource allocation approaches supported by ESOs in the healthcare sector. Despite explicit originalities in each approach, no network orchestration model prevails. Multi-polar coordination is the rule. Entrepreneurs' access to critical technological and cognitive resources is based on resource allocation modalities that differ for sponsored versus nonsponsored ESOs. Emerging from field research, this research also shows that sponsored and nonsponsored ESOs manage their roles in different ways because they confront original issues about organizational legitimacy.

Beyond the results listed above, the main originalities of the paper relate to the instantiation of multi-level analysis operated during field research and to the confrontation between sponsored versus nonsponsored ESOs in the domain of healthcare-related innovation management. This research shows that ESOs have practical relevance because they build original routes for resource allocation and network orchestration in EEs. Each ESO category (sponsored versus nonsponsored) provides original support for resource allocation. The ESO's legitimacy is inferred either from the sponsor or the services delivered to end-users. This research leads to propositions for future research and recommendations for practitioners: ESO managers, entrepreneurs, and policymakers.

This study aims to examine the level of intention to pursue formal nursing leadership roles among millennial nurses and to identify the different factors that may play a role in their intentions to pursue such roles.

This study used a multi-center, cross-sectional research design. Registered nurses born between 1980 and 2000 (n = 1,377) who worked in 23 acute care hospitals in Oman were included in this study. Data were analyzed using descriptive statistics and multiple linear regression. Data were collected between July 2019 and January 2020.

Nearly 70% of millennial nurses researched their intention for career advancement to assume nursing leadership responsibility. Factors associated with nurses’ intention to pursue formal nursing leadership roles were the type of nursing degree held (having a bachelor of science in nursing degree), type of hospital facility affiliation (teaching hospital), previous leadership experience, structural empowerment (access to support, opportunity and resources), work satisfaction and job burnout.

Millennial nurses, who represent the largest segment of the nursing workforce, have begun assuming nursing management and leadership roles; however, little is known about the factors affecting their intentions to pursue these roles. The findings of this study revealed different factors (both modifiable and nonmodifiable) influencing millennial nurses’ intentions to pursue formal leadership roles.

The purpose of this study is to examine the determinants of the level of indebtedness in the health sector in Portugal, taking into account the effects of the COVID-19 pandemic. At the same time, an attempt is made to understand whether the effect of a pandemic crisis is similar to that of a financial crisis.

To achieve this aim, two subperiods were analyzed: a global period between 2011 and 2020 that includes the pandemic crisis and the period between 2011 and 2014, designated as the financial assistance period by the “Troika” in Portugal. For a sample of 514 companies belonging to the NACE code: 86100 – activities of the health sector with hospitalization, the panel data methodology was applied, specifically, the generalized method of moments system proposed by Arellano and Bover (1995) and Blundell and Bond (1998).

The results of the study are in line with the Pecking-order explanatory theory, demonstrating that companies in this sector follow a financing hierarchy, preferentially resorting to internally generated funds and external debt. Additionally, the results reveal that the capital structure of companies has changed due to the COVID-19 pandemic. As for the period of financial assistance, there are no major differences in evidence when the total debt ratio is considered. The results suggest different impacts when it comes to a bear market period caused by a health crisis or a period of growing economic slowdowns.

As far as we know, this is the first study that analyses the debt levels in the context of the health sector in a country with a financial system based on the bank sector, using short- and long-term debt ratios, taking into account the particularities of two different moments considered to be bear market that may eventually be useful for comparison with other bear market moments in other macroeconomic environments.

El objetivo principal de este estudio es examinar los determinantes del nivel de endeudamiento en el sector de la salud en Portugal, teniendo en cuenta los efectos de la pandemia de COVID-19. Al mismo tiempo, se intenta comprender si el efecto de una crisis pandémica es similar al de una crisis financiera.

Para lograr este objetivo, se analizaron dos subperíodos: un período global entre 2011 y 2020 que incluye la crisis pandémica y el período entre 2011 y 2014, designado como el período de asistencia financiera por la “Troika” en Portugal. Para una muestra de 514 empresas pertenecientes al código NACE: 86100 – actividades del sector de la salud con hospitalización, se aplicó la metodología de datos de panel, específicamente, el método generalizado de momentos (GMM)-sistema propuesto por Arellano y Bover (1995) y Blundell y Bond (1998).

Los resultados del estudio están en línea con la teoría explicativa del “Pecking-order”, demostrando que las empresas en este sector siguen una jerarquía de financiamiento, recurriendo preferentemente a fondos generados internamente y deuda externa. Además, los resultados revelan que la estructura de capital de las empresas ha cambiado debido a la pandemia de COVID-19. En cuanto al período de asistencia financiera, no hay diferencias significativas en la evidencia cuando se considera la proporción total de deuda. Los resultados sugieren impactos diferentes cuando se trata de un período de mercado bajista causado por una crisis de salud o un período de crecimiento económico más lento.

Hasta donde sabemos, este es el primer estudio que analiza los niveles de deuda en el contexto del sector de la salud en un país con un sistema financiero basado en el sector bancario, utilizando ratios de deuda a corto y largo plazo, teniendo en cuenta las particularidades de dos momentos diferentes considerados como momentos de mercado bajista que eventualmente pueden ser útiles para comparar con otros momentos de mercado bajista en otros entornos macroeconómicos.

O principal objetivo deste estudo é examinar os determinantes do nível de endividamento no setor de saúde em Portugal, levando em consideração os efeitos da pandemia de COVID-19. Ao mesmo tempo, tenta-se compreender se o efeito de uma crise pandêmica é semelhante ao de uma crise financeira.

Para atingir esse objetivo, foram analisados dois subperíodos: um período global entre 2011 e 2020, que inclui a crise pandêmica, e o período entre 2011 e 2014, designado como o período de assistência financeira pela “Troika” em Portugal. Para uma amostra de 514 empresas pertencentes ao código NACE: 86100 – atividades do setor de saúde com hospitalização, foi aplicada a metodologia de dados em painel, especificamente o método generalizado de momentos (GMM)-sistema proposto por Arellano e Bover (1995) e Blundell e Bond (1998).

Os resultados do estudo estão de acordo com a teoria explicativa da ordem de preferência (“Pecking-order”), demonstrando que as empresas neste setor seguem uma hierarquia de financiamento, recorrendo preferencialmente a fundos gerados internamente e dívida externa. Além disso, os resultados revelam que a estrutura de capital das empresas mudou devido à pandemia de COVID-19. No que diz respeito ao período de assistência financeira, não há diferenças significativas na evidência quando se considera a proporção total de dívida. Os resultados sugerem impactos diferentes quando se trata de um período de mercado em baixa causado por uma crise de saúde ou um período de desaceleração econômica.

Até onde sabemos, este é o primeiro estudo que analisa os níveis de dívida no contexto do setor de saúde em um país com um sistema financeiro baseado no setor bancário, utilizando índices de dívida de curto e longo prazo, levando em consideração as particularidades de dois momentos diferentes considerados como momentos de mercado em baixa que eventualmente podem ser úteis para comparação com outros momentos de mercado em baixa em outros ambientes macroeconômicos.

This paper aims to determine the impact of mentorship on the development of self-directedness among beginner teachers in their initial years of teaching.

The researcher adopted a positivist paradigm to explore the situation of concern. Quantitative research was conducted, involving the collection and analysis of numerical data. Two closed-ended structured questionnaires were utilised, derived from the 40-item self-directed learning readiness scale (SDLRS) developed by Fisher and King, and a pre-determined questionnaire by Glazerman focused on the first-year teaching experience, induction and mentoring of beginner teachers.

Beginner teachers merely relying on the knowledge obtained from their studies is insufficient to achieve a satisfactory level of self-directedness when starting a teaching career. Most beginner teachers faced significant challenges in their early years of teaching due to the absence of mentoring support. In addition, most indicated that they resume their teaching duties and rely on their district for general support, guidance and orientation. Finally, the results have shown that mentoring positively impacts beginner teachers’ self-directedness.

The first limitation was that this study was narrowed to one South Africa University part-time B.Ed honours students working as beginner teachers in different provinces at primary and secondary schools. As a result, the findings of this research might be interpreted by some critics as one-sided and not representative of the views of most beginner teachers in South Africa who are working. The second limitation of this study is the sample size. In this study, 222 responses were received. As a result, the findings of this research might be considered not representative of the target sample size.

The presence and effective implementation of mentoring programmes in schools can positively impact beginner teachers' professional development and retention during their first years of teaching.

We contend that our research holds significance for international readership as it aims to garner attention towards potential research endeavours in diverse settings concerning mentorship programs for beginner teachers, specifically promoting self-directed learning. Our research offers opportunities to compare our findings with studies conducted in more comprehensive, comparative contexts and foster research possibilities in broader, contrasting contexts.

Based on the findings of this research, the availability and effective use of mentoring programmes would significantly affect beginner teachers' self-directedness, improve their retention rate and alleviate their teaching challenges. This study was the first research on the perceptions of the influence of mentoring on the self-directedness of beginner teachers.

The purpose of this study is to solve the problem of healthcare waste management in developing countries. The buildup of medical waste has attracted the attention of all spheres of society due to the expanding population and developing economy. Timely collection and processing of medical waste are extremely important due to its potential hazards. Although the problem of planning medical waste management has been addressed in developed countries, it persists in several developing countries. This research is motivated by an example of a city in India characterized by a dense population, abundant health-care facilities and a lack of planning for managing large medical waste generated daily.

The authors address the problem of designing the network of collection and processing facilities for medical waste and optimizing the vehicle route that collects and transfers the waste between facilities. Due to distinct topographic restrictions in the considered city, the collection and transfer process needs to be conducted in two echelons – from hospitals to collection centers using smaller vehicles and then to the processing facilities using trucks. This work addresses these two problems as a two-echelon location-routing problem.

A mixed-integer programming model is developed to minimize the cost of opening the facilities and transporting medical waste. Several managerial insights are drawn up to assist planners and decision-makers.

This study follows a case study approach to provide a descriptive and prescriptive approach to hospital waste management in the ancient city of Varanasi. The city has witnessed unplanned growth over the years and is densely populated. The health-care facilities in the city have a large catchment area and attract patients from neighboring districts. The situation analysis based on secondary data and unstructured interviews of the stakeholders suggests that the ad hoc approach prevails in present hospital waste management in the city.