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Health systems worldwide are hampered by disconnects between governance, management, and operations, which negatively impact on their ability to deliver efficient, effective, and safe healthcare services. This paper shows how insights from the Viable System Model (VSM) can help us to conceptualise health system disconnects impacting specialist clinical services and develop solutions to address organisational fragmentation.

A case study of a specialist clinical service was undertaken, where the VSM was used to guide semi-structured interviews and workshops with clinicians and managers and analysis of findings.

The VSM provides a coherent way to conceptualise the disconnects and identify their structural underpinnings. Three novel organisational pathologies emerged from the study.

This New Zealand-based study was undertaken during the COVID-19 pandemic and a period of major health system reform, introducing uncertainty into service provision that may have impacted stakeholders’ views.

The three novel pathologies affect how health systems define their services, their understanding of the management function, and the importance of coordination. The resulting clarity of functioning could improve service quality, staff and patient satisfaction, and the effectiveness and efficiency of healthcare service delivery.

This study contributes to the VSM literature on organisational pathologies by providing three novel pathologies for a perspective that may be useful beyond healthcare and invites consideration of health system disconnects as a coherent field of study.

The performance governance model, based on the use of performance information to improve governance, is particularly complex, considering the inter-institutional relationships and community involvement that it requires. In order to contribute to the scientific debate on this model, the paper aims to highlight what are the challenges in developing three variables of performance governance (operational performance measurement tools, governance integration and citizen involvement) in the public health context.

Based on the previous literature, we identified three variables that characterize the performance governance model. We then explored them through the case study methodology applied to the Apulia Regional Health System.

The analysis allows us to conclude that the healthcare system under consideration is still far from applying the performance governance model, but it highlights some factors that are preparatory to the same. Moreover, starting from the empirical evidence, some considerations arise regarding managerial and policy making implications for the variables investigated.

The paper contributes to a growing body of critical literature on performance governance contextualizing the analysis in a particularly relevant area of the public sector, namely public health. Furthermore, the research also identifies some potential risks of the performance governance model (rigidity in performance measurement tool, organization-objective-responsibility relationship, participatory illusion).

Peer support work is increasingly becoming part of the delivery of health and social care services. However, in an Irish context, there is a paucity of research in this area. This study aims to investigate the experiences of peers and other key stakeholders across four sectors in Ireland.

Qualitative interviews (N = 35) were conducted with key respondents in mental health, substance use, migrant health and homelessness sectors. Data were analysed using thematic analysis and reported using an ecological framework.

Peer work is a slowly emerging area of practice, although mental health is further ahead in this journey. Findings suggest that peers are important additions to service delivery but also have various support and development needs. Organisations can encourage and support peers into employment through enacting human resource policy and practices, effective supervision, management and maintaining a positive working culture. Helping other professionals to understand the peer role and how it can function within the wider team is highlighted. National policy and governance structures can also support the emergence of the peer role, which exists in a highly complex arena.

Peers can play a meaningful role in supporting service users in four sectors of health and social care in Ireland. Structures and processes to help embed these roles into systems are encouraged across micro, meso and macro levels. Implications and limitations are discussed for moving forward with peer work.

To the best of the authors’ knowledge, this is the first study to include these four areas of practice simultaneously.

This paper aims to identify the key issues that healthcare knowledge-intensive organizations (KIPOs) should focus on to define themselves as socioenvironmentally and governance responsible for integrating environmental, social, and governance (ESG) logic into their business strategy. At the same time, this provides an understanding of how healthcare KIPOs contribute to achieving the Sustainable Development Goals of the 2030 Agenda.

Taking a cue from the model developed by the World Economic Forum, an “ESG Processing Map” was constructed to identify qualitative disclosures that a healthcare company should consider when implementing sustainability logic. The aspects investigated were processed, considering national and international standards, frameworks and disclosures. The social network analysis technique was used to systemize and combine the outcomes of these processes and analyze their consistency with sustainable development.

Through the “ESG Processing Map,” 13 areas of action and 27 topics specific to the health sector were defined on which to intervene in sustainability in order to concretely help HCOs to place specific corrective and improvement actions over time concerning socioenvironmental and governance aspects.

The paper provides contribute, on the one hand, to enriching and updating the academic literature on ESG logic in a still underexplored field and, on the other hand, to provide these types of organizations with a “compass” to guide and orient their business strategies towards sustainability.

Healthcare organizations have been facing challenges due to high costs and low efficiency in health services. The growth of costs and losses caused by avoidable mistakes lead to the search for solutions, and Health Lean Management appears as a potential solution to help in solving service quality problems, as well as reducing risks. This study aims to analyse the state of the art in the literature centred on the Lean approach in the context of risk management in healthcare organizations, and to identify new research opportunities, highlighting possible lines of future research.

Following a systematic literature review approach, 51 papers were considered relevant for this research, and reviewed to explore the development of literature in this area.

Based on the results, five main research streams were identified: (1) risk management oriented towards patient safety; (2) risk management oriented towards employee safety; (3) importance of attitudes and behaviours in risk reduction projects; (4) Lean tools used in healthcare risk management and (5) Integration of approaches. Moreover, several shortcomings were identified in literature.

Identified shortcomings represent significant opportunities for further research development.

This study aims to investigate the adoption and use of electronic health record systems (EHRS) in Tanzanian public primary healthcare institutions. The study’s objectives include understanding the factors that affect EHRS adoption, identifying implementation challenges and evaluating the effect of EHRS usage on healthcare delivery. By addressing these research goals, the study aims to contribute insightful information on the current level of EHRS adoption in Tanzanian primary healthcare facilities and contribute to developing strategies to improve EHRS deployment and healthcare in the nation.

This study combined quantitative and qualitative data using a mixed-methods methodology. Both data types were collected and analysed concurrently using a concurrent triangulation approach. The study aimed to comprehend the variables that affect the adoption and use of EHRS in Tanzanian public primary healthcare institutions. Eleven regions spanning various geographic locations and urban–rural dynamics were chosen as research sites. A survey of 122 healthcare employees was conducted with a sample of 31 healthcare facilities. The questionnaire had closed-ended and open-ended questions to gather quantitative and qualitative data. Descriptive statistics and thematic analysis were used in data analysis. Throughout the investigation, ethical standards and confidentiality precautions were observed.

Several factors affect the adoption and use of EHRS. Perceived usefulness and use, support and training, interoperability, data security and privacy, business culture and leadership are all factors. Inadequate infrastructure, power interruptions, duplication of effort and a lack of data analytic expertise were among the difficulties. Among the effects were improvements in data management, service delivery and coordination, productivity and efficiency, medical supply inventory control, billing and revenue collection.

This study, which complements earlier research that has concentrated chiefly on specialised healthcare settings, gives new insights by investigating the adoption and utilisation of EHRS, especially in primary healthcare institutions. The findings give policymakers and healthcare professionals in Tanzania and other nations vital information to help them decide whether to embrace and use EHRS in primary healthcare.

Worldwide challenges impose public organizations to rethink their processes and satisfactorily meet citizens’ needs. Process mining (PM) techniques enable organizations to objectively analyse and improve their processes, by providing higher process transparency and efficiency. However, extant literature on PM applications in the public sector reveals there is still limited evidence on the opportunities and challenges perceived from PM introduction in the public sector, and on PM potential to enhance public sector digital transformation: this study aims to fill these gaps.

Based on Business Process Management and digital innovation fields of research, we administered a questionnaire to a sample of Italian civil servants working in different public organizations to investigate their perceptions of PM opportunities and challenges and the extent to which it can support public sector digital transformation. A three-level analysis was conducted to inspect findings with different levels of granularity, and results were analysed both descriptively and quantitatively.

We found a positive attitude towards PM introduction in the public sector, and perceived opportunities and challenges related to both the technical and the social systems. The triangulation between close-ended and open-ended questions suggests that PM could be the missing link between public sector digitalization and digital transformation. These findings can be used by policymakers to develop the best strategies to introduce PM into public organizations and support its adoption, and by researchers to further explore PM role in public sector digital transformation.

Despite PM claiming to push digital transformation, it is not clear if it is also true for public sector organizations. This paper addresses this gap and it is among the first attempts to explore PM from civil servants’ viewpoint to investigate their perceptions of PM opportunities and challenges, as well as the variables that influence these perceptions.

Recently, interest and necessity for cloud-based hospital information systems (HISs) have emerged as an appropriate alternative for revitalizing medical information exchange between hospitals, analyzing “big data” medical information and developing the use of new medical technologies. The purpose of this paper is to investigate factors that affect the switching of information systems in existing on-premise environments into cloud-based HISs.

A research model was developed using the push–pull–mooring model based on migration theory. The research model was analyzed using confirmatory factor analysis and path analysis using partial least squares structural equation modeling.

The results of this study showed that low compatibility, perceived value, low cost and inertia influenced the intention to switch to cloud-based HISs; low flexibility and low compatibility influenced dissatisfaction; and low cost, ease of maintenance and ease of managing indicators influenced perceived value.

This study is expected to be used as the basis for developing a research model in subsequent studies to analyze the transition to new innovative technologies. Also, in practice, it is expected to contribute to the activation of cloud computing environments in hospitals.

The purpose of this paper is to understand whether and how the Environmental, Social and Governance (ESG) paradigm can be useful in social reporting in the context of nonprofit healthcare organizations. In other words, the study deals with non-financial reporting and information, allowing external stakeholders to comprehensively evaluate the organization’s performance and behavior, investigating internal stakeholder perception over ESG paradigm application.

The authors used a case study approach investigating four cases among nonprofit healthcare organizations in Italy. Analyses of available primary sources have been conducted, followed by semi-structured interviews. Interviews were then transcribed and coded in a joint blinded process by all authors. More specifically, three areas have been investigated: (1) factors motivating the development of non-financial disclosure practices; (2) the rationale behind the organization’s decision to include specific topics; and (3) the future perspective on the future of non-financial disclosure within the specific sector.

ESG may serve as a suitable framework to create comparable documents that can act as benchmarks for similar institutions. However, while nonprofit organizations (NPOs) can draw inspiration from ESG, the utility of these criteria should be thoughtfully tailored to align with the organization’s mission. The ESG using as a general guide, instead of implementing it as a real tool to assess performances, emerges as a positive practice. NPOs should not focus on fulfilling ESG requirements bur rather take inspiration from them. Otherwise, the risk is an excess of focus on the formal aspect rather than on its content.

The study contributes to a better understanding of social and ESG’ reporting activities and approaches in the healthcare sector by describing some case studies and the effect of sustainability in the social reporting of nonprofit healthcare organizations.

This study aims to analyze the influence of the dimensions of Sharia hospital service standards, religiosity commitment and trust of Muslim patients on attitudes and satisfaction, as well as the implications of loyalty.

This study was carried out by analyzing data obtained from a survey with purposive sampling techniques with 425 patients in an Indonesian-certified Sharia hospital and analyzing it using partial least squares structural equation modeling software to test the path modeling and the relationship between the instruments.

This study shows that hospital amenities, doctor’s services, nurses’ services, health-care technicalities and hospital environmental and administrative behavior affect patient satisfaction. In addition, religiosity and trust in encouraging patient attitudes determine patient satisfaction. High satisfaction points will increase loyalty to Sharia hospitals.

This study encourages managers to maximize the quality of humanist Islamic medical services and the infrastructure of comfortable facilities. In addition, hospitals need to improve their holistic atmosphere, technical services and administrative behavior so that they can become essential value for hospital marketing – the development of competence and ethical behavior of health workers through various training programs internally and externally.

This study presents the determination of Sharia hospital service standards accompanied by a commitment to religiosity and trust as a psychological perspective of Muslim patients on attitudes and satisfaction and its implications on the brand loyalty of Indonesian Sharia hospitals that have been officially certified.