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The purpose of this study is to examine how servicescapes impact well-being and satisfaction of both hospital customers (patients) and health care professional service providers.

The study investigates how a hospital servicescape impacts two critical outcomes – well-being and satisfaction – of both hospital patients (customers) and health care professionals, who are immersed in that environment.

The hospital servicescape had a greater impact on physical, psychological and existential well-being for professionals than for patients. However, the reverse was true for satisfaction. The new servicescape enhanced the satisfaction and physical and psychological well-being of professionals but only the satisfaction of customers.

The study implications for health care policy suggest that investment in health care-built environments should balance the needs of health care professionals with those of customers to benefit their collective well-being and satisfaction.

Based on the findings, the authors propose that servicescape investments should focus on satisfying the physical needs of patients while also placing emphasis on the psychological needs of professionals.

Health care spending on physical facilities should incorporate careful cost-benefit analysis, ensuring that beneficial features for both user groups are included in new hospital designs, omitting features that are less supportive of well-being.

To the best of the authors’ knowledge, this study is the first to compare the impact of the same real-life servicescape on the satisfaction of both customers and service providers (professionals) and considers the critical health outcome of well-being.

Prior studies have shown that physician-led hospitals have several advantages over non-physician-led hospitals. This study seeks to test whether these advantages also extend to periods of extreme disruptions such as the COVID-19 pandemic, which affect bed availability and hospital utilization.

The authors utilize a bounded Tobit estimation to identify differences in patient satisfaction rates and in-hospital utilization rates of top-rated hospitals in the United States.

Among top-rated US hospitals, those that are physician-led achieve higher patient satisfaction ratings and are more likely to have higher utilization rates.

While the COVID-19 pandemic generated greater demand for inpatient beds, physician-led hospitals improved their hospitals’ capacity utilization as compared with those led by non-physician leaders. A longitudinal study to show the change over the years and whether physician Chief Executive Officers (CEOs) are more likely to improve their hospitals’ ratings than non-physician CEOs is highly recommended.

Recruiting and retaining physicians to lead hospitals, especially during disruptions, improve hospital’s operating efficiency and enhance patient satisfaction.

The paper reviews prior research on physician leadership and adds further insights into the crisis leadership literature. The authors provide evidence based on quantitative data analysis that during the COVID-19 pandemic, physician-led top-rated US hospitals experienced an improvement in operating efficiency.

There is evidence that quality improvement projects developed with the participation of patients and family members are more likely to result in a sustainable change. To identify the intervening factors is an important step in promoting and supporting patient and family members’ engagement.

A survey was carried out with 90 hospitals. A total of 35 intervening factors were evaluated by the healthcare professionals from the quality area using a Likert scale. Factor analysis was applied to identify the relationship among the factors and cluster analysis and the standardized scores for each new latent variable were obtained to observe the association between them and hospitals profile. Cluster analysis allowed to group the hospitals with similar responses and to analyze whether there was any association with the profile of the institutions.

A total of ten intervening factors are identified: two in the financial dimension, five in the structural and three in the personal and cultural. The standardized scores of latent variables suggest that the financial factors could be affected by the hospital capacity. The structural factors could be impacted by the accreditation status, location (region) and administrative control (ownership). And the personal and cultural factors could be by the location and dominant organizational culture. All of factors are influenced by the performed quality management activities. The cluster analysis allowed the identification of three groups in the financial dimension, and four in the other two dimensions. Except for the accreditation status in the personal and cultural dimension, no evidence of association between the groups and the variables raised to characterize the profile of the hospitals was found.

The study contributed to identify the relationship among the intervening factors turning possible to simplify and reduce them more comprehensively than those originally identified in the literature and at the same time maintaining the representativeness of the original variables.

The impact of the COVID-19 pandemic on healthcare operations has raised questions about the applicability and capacity of the lean approach to respond to critical events. Thus, with a dearth of studies addressing this issue, this study aims to understand the role of lean in healthcare operations under the disruptive impact of the COVID-19 pandemic.

Drawing on a case study carried out in an emergency department in Brazil during the COVID-19 outbreak, the author presents results from semi-structured interviews and document analysis.

The results show three prominent themes that respond to this study's purpose: lean applicability during the pandemic, lean challenges during the pandemic and the pandemic impact on the lean processes. Furthermore, the study underscores that lean is not the panacea to operational problems caused by the pandemic in healthcare organisations, but it eases the impact on their operations. Finally, this study contributes to the discipline of operations management and highlights the need to rethink lean applications during disruptive events, focusing on flexibility, adaptability and patients' needs.

The literature addressing the pandemic impact on healthcare operations is still new and emerging; therefore, it is possible that some of the studies that are under review and could contribute to this study were not considered.

The study provides a better understanding of the lessons learned from the real-world experiences gained during the pandemic, helping managers to make informed decisions when developing contingency plans to improve healthcare readiness and responsiveness under crisis conditions (e.g. untenable demand and constrained capacity).

Given the contemporary nature of this pandemic, only few emerging studies addressing the impact of the pandemic on lean healthcare operations are available and scholars are calling for more empirical studies. Furthermore, there is an increasing criticism and scepticism about the applicability of lean in healthcare during a pandemic. Thus, this research both provides original contributions by responding to scholars' calls for novel research in this area and further contributes towards filling the void in the literature.

The authors determine how the scheduling and sequencing of surgeries by surgeons impacts the rate of post-surgical complications and patient length-of-stay in the hospital.

Leveraging a dataset of 29,169 surgeries performed by 111 surgeons from a large hospital network in Ontario, Canada, the authors perform a matched case-control regression analysis. The empirical findings are contextualized by interviews with surgeons from the authors’ dataset.

Surgical complications and longer hospital stays are more likely to occur in technically complex surgeries that follow a similarly complex surgery. The increased complication risk and length-of-hospital-stay is not mitigated by scheduling greater slack time between surgeries nor is it isolated to a few problematic surgery types, surgeons, surgical team configurations or temporal factors such as the timing of surgery within an operating day.

There are four major limitations: (1) the inability to access data that reveals the cognition behind the behavior of the task performer and then directly links this behavior to quality outcomes; (2) the authors’ definition of task complexity may be too simplistic; (3) the authors’ analysis is predicated on the fact that surgeons in the study are independent contractors with hospital privileges and are responsible for scheduling the patients they operate on rather than outsourcing this responsibility to a scheduler (i.e. either a software system or an administrative professional); (4) although the empirical strategy attempts to control for confounding factors and selection bias in the estimate of the treatment effects, the authors cannot rule out that an unobserved confounder may be driving the results.

The study demonstrates that the scheduling and sequencing of patients can affect service quality outcomes (i.e. post-surgical complications) and investigates the effect that two operational levers have on performance. In particular, the authors find that introducing additional slack time between surgeries does not reduce the odds of back-to-back complications. This result runs counter to the traditional operations management perspective, which suggests scheduling more slack time between tasks may prevent or mitigate issues as they arise. However, the authors do find evidence suggesting that the risk of back-to-back complications may be reduced when surgical pairings are less complex and when the method involved in performing consecutive surgeries varies. Thus, interspersing procedures of different complexity levels may help to prevent poor quality outcomes.

The authors empirically connect choices made in scheduling work that varies in task complexity and to patient-centric health outcomes. The results have implications for achieving high-quality outcomes in settings where professionals deliver a variety of technically complex services.

The authors examine how physician staffing, human capital and knowledge spillovers are related to multiple dimensions of hospital operational and financial performance at the organizational level.

The authors use a data set assembled from multiple sources for more than 1,300 US hospitals and employ hierarchical linear regression to test this study’s hypotheses. The authors use multiple quality, efficiency and financial measures of performance for these hospitals.

The authors find that higher levels of staffing, skills and knowledge spillovers associated with physicians were positively associated with multiple dimensions of hospital performance. The authors find linear and nonlinear relationships between experience and performance, with the relationships primarily negative, and nonlinear relationships between spillovers and quality performance.

Hospital managers should consider increasing physician staffing levels if possible. In addition, the overall Final MIPS Score from the Centers for Medicare and Medicaid Services might be included as a factor in determining which physicians practice in a hospital. Finally, if possible, encouraging physicians to practice at multiple hospitals will likely be beneficial to hospital performance.

This study’s findings are original in that they explore how physician-specific staffing and human capital, which have received comparatively little attention in the literature, are related to several different dimensions of hospital-level operational and financial performance. To the best of the authors’ knowledge, this paper is also the first to examine the relationship between the construct of physician knowledge spillovers and hospital-level operational and financial performance.

This paper aims to investigate the role of value measuring (VM) as an integrated part of a deal introduced to govern the cross-boundary relationship of state specialist- and primary care providers in the Norwegian health sector.

Drawing on a longitudinal ethnographic case study, this study explores the role of payment for dischargeable patients (PDP), an incentive arrangement introduced as a mechanism of value appropriation intended to create stability in the relationship and support improved patient flows between care providers. The fieldwork took place over approximately 18 months, consisting of intensive participant observations, interviews and document studies.

The VM integrated in the PDP deal between the hospital and municipality, on the surface level, appears simple. The VM, however, rests on a very complex practice of information sharing where accounts on patient status, procedures and activities form the basis of the integrated VM. The deal and its VM, despite its ambitious aims, were not able to fulfill the expectations of a smooth appropriation of value through the management of monetary flows or supporting information sharing for value creation. The VM of the PDP deal aimed at bringing the parties closer together, rather created a distance where money matters became a source of tension.

This study investigates the interconnections of deals and VM in a public sector service context, showing aspects of deals different from that of prior studies into private sector deals.

This case study is designed to enable students to analyze the competitive landscape of a business impacted by technological disruption; evaluate the viability of an organic growth strategy using stakeholder analysis; evaluate the revenue and cost structure of Apollo 24/7 and decide on the future investment strategy; and analyze funding strategies of traditional hospitals versus pure digital players.

To extend its reach, Apollo Hospitals Enterprise (Apollo Hospitals), a leading private sector brick-and-mortar hospital chain in India known for using state-of-the-art technology, launched a unified virtual mobile platform Apollo 24/7 in February 2020, 45 days into the COVID-19 pandemic. The management believed that the digital platform had a unique ecosystem that could not be replicated. The analysts were optimistic about the impact of the decision on the future performance of Apollo Hospitals, as it was expected to lead to higher penetration and increased revenue. They also anticipated the unlocking of value, as and when the venture capitalist (VC) would invest in Apollo Hospitals. However, with increasing operating expenses on account of burgeoning technological and marketing expenses, things did not seem to go going as planned. Three years later, in February 2022 after the Q3 of financial year 2023 results. Suneeta Reddy, the company’s managing director found herself pondering whether the digital platform could boost Apollo Hospitals’ profitability in addition to expanding its reach and increasing affordability when the company missed the analyst estimates. In India, which was then the second most populous country, “incremental access” and “affordability” were what mattered to the patients, However, for the investors and analysts, it was quarter-on-quarter performance. The change in the macroeconomic environment stalled the company’s plan of raising money from VCs.

Furthermore, the financing dilemma also plagued Reddy. She knew there was a difference between financing for conventional businesses that for digital businesses. She also had to take decide between short-term profitability with which investors were obsessed versus long-term sustainability, which involved taking care of stakeholders’ interests.

This case study is basically aimed at postgraduate courses and executive management courses.

Teaching notes are available for educators only.

CSS11: Strategy.

Employee recognition systems are ubiquitous in organizations (WorldatWork, 2019) and have positive effects on work outcomes (e.g. Stajkovic and Luthans, 2001). However, psychologically meaningful recognition relies on the recognition giver being motivated to observe and recognize coworkers. Crises such as the COVID-19 pandemic may impact recognition giving in varying ways, yet little research considers this possibility.

This longitudinal field study examined the impact of the COVID-19 crisis on recognition and acknowledgment giving among frontline and nonfrontline healthcare workers at daily and aggregated levels. We tested the relationships between publicly available daily indicators of COVID-19 and objectively measured daily recognition and acknowledgment giving within a web-based platform.

We found that the amount of daily recognition giving was no different during the crisis compared to the year before, but fewer employees gave recognition, and significantly more recognition was given on days when COVID-19 indicators were relatively high. In contrast, the amount of acknowledgment giving was significantly lower in frontline staff and significantly higher in nonfrontline staff during the pandemic than before, but on a daily-level, acknowledgment was unrelated to COVID-19 indicators.

Our results suggest that organizational crises may at once inhibit and stimulate employee recognition and acknowledgment.

Our research is the first to empirically demonstrate that situational factors associated with a crisis can impact recognition giving behavior, and they do so in ways consistent with ostensibly contradictory theories.

This study aims to examine the perceptions and evaluations of Muslim COVID-19 survivors and health workers regarding the halal, business and ethical attributes of hospitals during their interactions related to COVID-19 treatment.

Descriptive qualitative research with semi-structured online interviews was used to gather insights from COVID-19 survivors and health workers who treated COVID-19 patients. The findings were then compared with existing literature on hospital services and Sharia attributes.

The study found that patients and health-care workers in hospitals are concerned about whether the hospital follows Sharia law, the quality of health-care and hospital services and the ethical conduct of hospital staff. This is especially true during the COVID-19 pandemic, when patients are more anxious about religious conduct and the afterlife.

Hospitals need to address halal attributes in all aspects of their services for Muslim patients and business attributes such as standard health-care quality, service quality and ethical attributes. Participants indicated that when these needs are met, they are more likely to revisit the hospital and recommend it to others.

This study contributes to understanding the expectations of Muslim patients regarding hospital services that meet Islamic ethical and business requirements. Using the COVID-19 pandemic as a case study broadens the understanding of how to better serve Muslim customers.