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The purpose of this paper is to review the causes of long waiting time in Hong Kong public hospitals and to suggest solutions in the service, organisational, systems, financial and policy perspectives.

The paper is a review of waiting time of public hospital services. Total joint replacement, which is one of the elective surgeries in public hospitals, is presented as a case study.

The average waiting time of semi-urgent and non-urgent patients in the accident and emergency departments of public hospitals is two hours, and that of specialist outpatient (SOP) clinics is from 1 to 144 weeks. For total joint replacement, it is from 36 to 110 months. Measures like Government subsidisation programme for the replacement surgery and employing adequate physiotherapists, Chinese medicine practitioners, clinical psychologists and nurses to reduce the waiting time are suggested. Issues concerning the healthcare system of Hong Kong, such as structural reform, service delivery model, primary care, quality and process management, and policy reviews, are also discussed.

The ‬over-reliance of public services has resulted in long waiting time in public hospitals in Hong Kong, particularly in the emergency services and SOP clinics. However, the consequences of long waiting period for surgical operations, though much less discussed by the media and public, can be potentially detrimental to the patients and families, and may result in more burdens to the already stretched public hospitals‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬.

Did Chinese cities whose public health departments are headed by medical professionals fare better in fighting coronavirus disease 2019 (COVID-19)?

The authors collected the professional background of the directors of the public health departments of 350 Chinese cities, which include 87% of the Chinese population. Excluding Wuhan, the epicenter of COVID-19, the authors analyzed the infection rates and death rates from COVID-19 between 131 Chinese cities whose public health departments are led by medical professionals and 218 cities whose public health departments are led by nonprofessionals. The authors employed a multivariate regression controlling for the number of people that traveled from Wuhan to each city, the local economic development and the number of hospital beds.

Chinese cities whose public health departments are led by medical professionals had 21 fewer confirmed cases per 10 million as of January 31, 2020 [95% CI, −40 to −3], 58 fewer cases per 10 million in the next 10 days [95% CI, −116 to 0], similar new cases between February 11 and February 20, 2020, and 3 fewer deaths per 10 million as of February 20, 2020 [95% CI, −7 to 0].

Association could not make a strong causal claim.

Local public health authorities are critical for combating a pandemic. The authors found that Chinese cities whose public health departments are headed by medical professionals were associated with lower infection rates and fewer death rates from COVID-19. The results were significant only at the start of the outbreak. This study’s results suggest that to better combat a pandemic, local public health authorities should be led by competent people who have a medical background.

The authors provide the first empirical evidence about the association between a local public health head's competence and the infection rate and death rate of COVID-19. The authors’ manually collected data also show that only 38% of the heads of the public health departments of Chinese cities have a medical background.

The purposes of this paper are two-fold: first, to introduce a new concept of primary care consultation system at a mainland Chinese hospital in response to healthcare reform; and second, to explore the factors associated with change resistance and acceptance from both patients’ and medical staff’s perspectives.

A survey design study, with two questionnaires developed and distributed to patients and medical staff. Convenience and stratified random sampling methods were applied to patient and medical staff samples.

A 5-dimension, 21-item patient questionnaire and a 4-dimension, 16-item staff questionnaire were identified and confirmed, with 1020 patients (91.07 percent) and 202 staff (90.18 percent) as effective survey participants. The results revealed that patient resistance mainly stems from a lack of personal experiences with visiting general practice (GP) and being educated or having lived overseas; while staff resistance came from occupation, education, GP training certificate, and knowledge and experience with specialists. Living in overseas and knowledge of GP concepts, gender and education are associated with resistance of accepting the new practice model for both patients and staff.

There are few Chinese studies on process reengineering in the medical sector; this is the first study to adopt this medical consultation model and change in patients’ consultation culture in Mainland China. Applying organizational change and process reengineering theories to medical and healthcare services not only extends and expands hospital management theory but also allows investigation of modern hospital management practice. The experience from this study can serve as a reference to promote this new consultation model in Chinese healthcare reform.

Guided by the growing importance of social-mediated organisational communication, this study examines how communication professionals within healthcare organisations perceive and respond to the reputation impacts of social media on the organisation’s reputation. Although the healthcare sector finds itself in the midst of a (continually) transforming landscape characterised by large amounts of digital health (mis)information and an empowered “patient-as-consumer”, little is known about how professionals in this sector understand the changes and respond to them. Moreover, much extant scholarship on the topic is published in specialised health or medical journals and does not explicitly address the communication implications for healthcare organisations.

In-depth semi-structured interviews were conducted with communication professionals responsible for social media across eight hospitals in the Netherlands. The sample included two participants working as communication consultants/social media advisors for healthcare organisations. In all, 15 interviews were conducted.

Building on interviewee perspectives, the authors advance the CARE (Control, Access(ability), Responsive(ness) and Engagement) model of social-mediated communication, highlighting the dualistic characteristics of each dimension. This model is built upon a careful analysis of healthcare professional responses. In an always-on environment, understanding and managing the tensions within the authors’ model may be decisive to the reputation implications of social media use.

Understanding the tensions within each dimension lends a more nuanced perspective on the potential impact(s) of social media as experienced by professionals in the field. In shifting away from a binary, either/or approach, the paper contributes to explicating the complexities of a pervasive phenomenon (i.e. social-mediated communication) and its multifaceted impacts on the healthcare sector.

Doctors' labour and medicines are special necessities for human survival and evolution. Since China launched the healthcare reform, the theoretical circles' discussions have not yet clarified the respective special properties of doctors' labour and medicines as goods and the internal relations between doctors' labour and medicines at the level of the theoretical basis.

Health is a prerequisite for people's all-round development, a precondition for economic and social development and the people's common aspiration. The all-round moderately prosperous society could not be achieved without people's all-round health.

The authors believe the socialist relation between doctors' labour and medicines with Chinese characteristics should be one that is people-oriented, and the corporatization of hospitals or the capitalization of doctors' labour should be avoided.

In this paper, the authors explore the particularity of doctors' labour, particularity of medicine production, circulation, consumption and the internal relations between doctors' labour and medicines by using the analytical approach of Marxist political economy while considering the special roles of doctor's labour and medicines in the reproduction of labour power and put forward the theoretical basis for the segregation of doctor's labour and medicines.

With the government’s increased investment in sci-tech and the requirement of scientific research management, RMAs have gradually flourished in China after the 1980s. However, there is no professional qualification specifically for RMA in China and RMA professionals are from various departments. With the arrival of the 21st century, the rapid development of sci-tech has led to the strengthening of the position and role of RMA in research activities. The profession of RMA has made great progress, and a professional contingent of RMA has gradually been formed. This chapter will review the history and development of RMAs in China. Specifically, it includes the evolutionary history of China’s sci-tech policy, how RMAs developed as a profession, current state of RMAs, the size and nature of the RMA profession (taking the academic community CASSSP as an example), and future trends of RMAs in China.

The purpose of this paper is to review cases about complaints of abortuses handling in Hong Kong, and to further propose policy recommendations to help comfort parents with respect and dignity toward abortuses.

There is a systematic review of articles/newspapers related to the practice and regulation of abortuses handling in Hong Kong and overseas countries. Also, point of views among stakeholders are selected from: newspapers, patients’ groups, Hong Kong SAR Government’s websites, radio programmes’ interviews, related organizations’ websites, blogs from legislative councilors and lawyers.

Since parents suffered from miscarriage before 24 weeks’ pregnancy are increasingly willing to share their experiences and struggled for arranging a legal funeral for their children, Hong Kong SAR Government is able to understand these parents’ needs and hence set up more “Angel Garden” in both the public and the private cemeteries. Yet, the provision of funeral and cremation services are still not comprehensive. Existing measures from Mainland China and overseas countries to handle abortuses and to provide support for parents are analyzed. More critically, ethical concern on handling abortuses as one of the clinical wastes is further included in the discussion.

Although all less than 24 weeks’ fetuses cannot be given any Certificate of Stillbirth, respect and dignity can still be presented toward their parents by flexible regulation. After discussing the related measures on handling abortuses from other countries, some of their humane regulations are feasible to be applied to Hong Kong.

Lean Six Sigma in public and private healthcare organisations has received considerable attention over the last decade. Nevertheless, such process improvement methodologies are not generalizable, and their effective implementation relies on contextual variables. The purpose of this study is to explore the readiness of Italian hospitals for Lean Six Sigma and Quality Performance Improvement (LSS&QPI), with a focus on gender differences.

A survey comprising 441 healthcare professionals from public and private hospitals was conducted. Multivariate analysis of variance was used to determine the mean scores on the LSS&QPI dimensions based on hospital type, gender and their interaction.

The results showed that public healthcare professional are more aware of quality performance improvement initiatives than private healthcare professionals. Moreover, gender differences emerged according to the type of hospital, with higher awareness for men than women in public hospitals, whereas for private hospitals the opposite was true.

This study contributes to the Lean Six Sigma literature by focusing on the holistic assessment of LSS&QPI implementation.

This study informs healthcare managers about the revolution within healthcare organisations, especially public ones. Healthcare managers should spend time understanding Lean Six Sigma as a strategic orientation to promote the “lean hospital”, improving processes and fostering patient-centredness.

This is a preliminary study focussing on analysing inter-relationship between perceived importance of soft readiness factors such as gender dynamics as a missing jigsaw in the current literature. In addition, the research advances a holistic assessment of LSS&QPI, which sets it apart from the studies on single initiatives that have been documented to date.

Society is critically dependent on an adequate supply of hospital doctors to ensure optimal health care. Voluntary turnover amongst hospital doctors is, however, an increasing problem for hospitals. The aim of this study was to systematically review the extant academic literature to obtain a comprehensive understanding of the current knowledge base on hospital doctor turnover and retention. In addition to this, we synthesise the most common methodological approaches used before then offering an agenda to guide future research.

Adopting the PRISMA methodology, we conducted a systematic literature search of four databases, namely CINAHL, MEDLINE, PsycINFO and Web of Science.

We identified 51 papers that empirically examined hospital doctor turnover and retention. Most of these papers were quantitative, cross-sectional studies focussed on meso-level predictors of doctor turnover.

Selection criteria concentrated on doctors who worked in hospitals, which limited knowledge of one area of the healthcare environment. The review could disregard relevant articles, such as those that discuss the turnover and retention of doctors in other specialities, including general practitioners. Additionally, being limited to peer-reviewed published journals eliminates grey literature such as dissertations, reports and case studies, which may bring impactful results.

Globally, hospital doctor turnover is a prevalent issue that is influenced by a variety of factors. However, a lack of focus on doctors who remain in their job hinders a comprehensive understanding of the issue. Conducting “stay interviews” with doctors could provide valuable insight into what motivates them to remain and what could be done to enhance their work conditions. In addition, hospital management and recruiters should consider aspects of job embeddedness that occur outside of the workplace, such as facilitating connections outside of work. By resolving these concerns, hospitals can retain physicians more effectively and enhance their overall retention efforts.

Focussing on the reasons why employees remain with an organisation can have significant social repercussions. When organisations invest in gaining an understanding of what motivates their employees to stay in the job, they are better able to establish a positive work environment that likely to promote employee well-being and job satisfaction. This can result in enhanced job performance, increased productivity and higher employee retention rates, all of which are advantageous to the organisation and its employees.

The review concludes that there has been little consideration of the retention, as opposed to the turnover, of hospital doctors. We argue that more expansive methodological approaches would be useful, with more qualitative approaches likely to be particularly useful. We also call on future researchers to consider focussing further on why doctors remain in posts when so many are leaving.

This paper attempts to theorise about China’s strategy in combating the coronavirus pandemic with an embryonic framework - 3H (Heart-Head-Hand) framework. By adopting a descriptive approach, the paper introduces the case of coronavirus outbreak in China and how the public health administration coped with it. The 3H framework has been applied to analyse China’s strategy, and the framework’s assumptions are initially tested.

The pandemic case is created based on credible reports, press releases from different respected sources, World Health Organization (WHO) statistics, interview transcripts and broadcasting stations’ video clippings. Interpretive analysis with pragmatism approach has been conducted in analysing the data and information collected. Triangulation, wherever possible, has been done to validate the data and information.

As an exploratory study, its findings show that 3H framework distinguishes the effectiveness of a country’s strategy and practice for combating the pandemic. Countries, which failed to observe the assumed principles of 3H domains tend to have much more infected cases and deaths.

The 3H framework conceptualised a holistic management approach and its assumptions have been initially tested with this pandemic case. The framework shows its predictability value for a country’s pandemic management effectiveness.