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The integration of industry 4.0 has become a priority for many organizations. However, not all organizations are suitable and capable of implementing industry 4.0 because it requires a dynamic and flexible implementation strategy. The implementation of industry 4.0 often involves overcoming several tensions between internal and external stakeholders. This paper aims to explore the paradoxical tensions that arise for health-care organizations when integrating industry 4.0. Moreover, it discusses how a paradox lens can support the conceptualization and proposes techniques for handling tensions during the integration of industry 4.0.

This qualitative and in-depth study draws upon 32 semi-structured interviews. The empirical case concerns how two health-care organizations handle paradoxical tensions during the integration of industry 4.0.

The exploration resulted in six recurring technology tensions: technology invention (modularized design vs. flexible design), technology collaboration (automation vs. human augmentation), technology-driven patient experience (control vs. autonomy), technology uncertainty (short-term experimentation vs. long-term planning), technology invention and diffusion through collaborative efforts among stakeholders (selective vs. intensive collaboration) and technological innovation (market maintenance vs. disruption).

A paradox theory-informed conceptual model is proposed for how to handle tensions during the integration of industry 4.0. To the best of the authors’ knowledge, this is the first paper to introduce paradox theory for quality management, including lean and Six Sigma.

Investigating the role of leadership during the COVID-19 pandemic in maintaining the well-being and performance of the medical personnel, as frontline workers, is of major importance. The aim of this study was to investigate the relationships between engaging leadership in health care during COVID-19 pandemic and followers’ work engagement and performance and to test the mediating role of followers’ basic psychological need satisfaction in these relationships.

A cross-sectional study was conducted on a sample consisting of 200 health-care employees. Data were collected starting with May 2020 and ending with November 2020, during the COVID-19 pandemic. Participants reported on the engaging leadership of their direct supervisor and on their own psychological need satisfaction, work meaningfulness, work engagement and quality of care.

The positive association between engaging leadership and followers’ work engagement was fully mediated by followers’ basic needs satisfaction. The relationship between engaging leadership and followers’ quality of patient care was not supported. Work meaningfulness did not mediate the link between engaging leadership and followers’ engagement.

By meeting followers’ needs for autonomy, competence and relatedness, engaging leaders can stimulate followers’ work engagement during outbreaks and other similar crises. Managers in health care may maintain a high level of followers’ work engagement during crises if they adopt an engaging leadership style.

The study investigated for the first time the role of meeting the psychological needs of health-care workers by leaders during a health-care crisis.

This study aims to examine the conceptual and empirical operations of hospitality at its intersections with health care, which includes medical and senior care.

This study conducts a systematic review of literature on hospitality in health care published in hospitality, tourism and leisure journals spanning from 1990 to 2023. A total of 50 studies meeting the inclusion criteria are reviewed, providing insights into how hospitality is conceptualized, its practical implementation and the proposed outcomes in health-care settings.

Hospitality in health care is conceptualized by hospitality scholars in three main ways: as service functions, as a service exchange and as an organizational culture. There is a significant overlap between the notion of hospitality and the concept of person-centered care in gerontology and health-care literature. Also, hospitality contributes positively to patient/resident experiences, organizational performance and societal impacts.

The study is limited by its focus solely on the theoretical and practical aspects of hospitality in health care within hospitality, tourism and leisure journals, excluding relevant literature from gerontological and health-care journals.

Interdisciplinary research requires scholars from different disciplines to develop a common language and understanding of key concepts. This study presents the conceptual and practical domains of hospitality and its relevancy to health-care research and offers future directions to strengthen the interdisciplinary research between hospitality, health care and gerontology.

The Canadian Society for Medical Laboratory Science (CSMLS) Peer Support Project was a formal and virtual peer support group pilot for medical laboratory professionals in Canada to determine its application for CSMLS members and obtain information regarding the current state of medical laboratory professionals’ mental health, well-being and burnout. CSMLS learned what is contributing to stress at work, coping strategies and barriers to accessing support or help for their mental health among medical laboratory professionals.

The qualitative and exploratory pilot study examined medical laboratory professionals from Canada. Two peer support groups were facilitated in April and May 2022 by a trained mental health clinician. Peer support delivery was virtual and delivered via Zoom. The purposive sample featured medical laboratory technologists, Educators and Supervisors/Directors who were CSMLS members. The qualitative analysis was conducted via analytical memos and incorporated both manual and NVivo software analysis.

Overall themes were identified within the data analysis and included barriers to mental health care; increased stigma for mental health; mixed messaging regarding mental health; feeling invisible; medical laboratory professionals would like to manage stress better but their increasing workload demands and challenges with scheduling and staffing add to their stress. Participants also highlighted their role and its context using metaphors such as “the silent firefighters”, and “the Bass Guitar of the Hospital”. Based on the evaluations, the peer support sessions encouraged participants to address their own mental health, validate their experiences and increase their comfort level in discussing mental health.

It identified a potential resource for medical laboratory professionals and determined that further mental health resources would be beneficial for their field. It also identified their strong commitment to patient care and their role as a medical laboratory professional.

To the best of the authors’ knowledge, this study is one of the first to examine peer support as a mental health resource for medical laboratory professionals. Additionally, its focus was on a Canadian population with virtual delivery.

The patient flow performance achievable by care pathways is constrained by competing flow and resource efficiency, which can negatively impact improvements. This paper probes the divergence between resource and flow efficiency and how care pathways can lead to improved patient flow. By framing the problem through the lens of paradox theory, a set of design principles is proposed to assist decision-makers in care pathway implementation. Implications are derived for research and practice.

The authors used conceptual research to develop design principles for care pathways based on a systematic review of relevant care pathway research. The initial search contained 515 unique articles, resulting in a final sample of 56 studies.

When applying care pathways, patient flow may be negatively affected in relation to the dimensions of bottlenecks, non-value-adding activities, and variability. However, the findings also indicate methods that can be applied to manage organizational paradoxes, which can contribute to more efficient patient flow along each of the three dimensions.

The study is limited to care pathways and therefore could have missed relevant studies in similar fields, such as care coordination.

Health care managers, politicians, and IT developers can apply the proposed design principles when developing, implementing, and improving care pathways and supporting technologies.

While existing research has studied care pathways from a medical perspective, this is the first paper to the author’s knowledge that addresses care pathways directly by considering paradox theory and in light of the operations management literature.

Emotional intelligence (EI) and authentic leadership are essential attributes for effective healthcare management. Understanding their interplay can inform leadership development and improve patient care outcomes. This study aims to determine the relationship between EI and authentic leadership among nurse managers.

Study conducted a cross-sectional study, collecting data from 198 nurse managers using surveys assessing EI and authentic leadership. Correlation and regression analyses were used to explore the relationship and impact of EI on authentic leadership. STROBE checklist used to report the study.

The findings revealed a positive and significant relationship between nurse managers’ EI and their authentic leadership characteristics. Higher EI scores were associated with increased authenticity in leadership. EI, particularly interpersonal EI, plays a crucial role in authentic leadership. Enhancing nurse managers’ EI can foster more authentic leadership, positively impacting healthcare settings.

This research underscores the importance of EI in leadership development and its potential for improving patient care and organizational outcomes.

Quality improvement has developed and spread, and today, all Swedish Regions emphasize that their strategies are based on systematic improvement. This paper aims to describe and illuminate the development of Quality Improvement (QI) in Swedish healthcare and welfare organizations by using publications in a Swedish context.

The overview synthesis is inspired by a scoping literature review approach of relevant literature. All publications relevant to Swedish healthcare and welfare settings between 1992 until 2020 were included.

In all, 213 papers, 29 books and chapters and 34 dissertations related to QI and research in Swedish healthcare and welfare context were identified. From 2011 to 2020, the publication rate increased rapidly. Six different focus areas emerged: systematic and value-creating improvement work; collaboration between organizations and healthcare providers; use of improvement methods and (theoretical) models; leadership and learning; measurements, quality registers and follow-up; and involvement and patient safety. Further QI development in Swedish healthcare and welfare points to an increased importance of collaboration between organizations and coproduction with beneficiaries for the healthcare and welfare services.

This paper is one of the first to describe and illuminate the QI development in the healthcare and welfare sector in a country. The trajectory also points to a need for coproduction to handle future challenges.

This study finds out if a satisfied physician will show citizenship behaviour (OCB) in a work environment where psychological contract breach (PCB) exist.

Quantitative data from 214 physicians across 26 health-care units were analysed. Research philosophy was positivism, research design was explanatory and study design was cross-sectional. Preliminary tests were conducted. Reflective measurement and structural models were examined. PLS algorithm tool and bootstrapping procedure were utilised. Control variables were sex, age, employment type and tenure. A significant level was set at 5%. Smart PLS 2.0M.3 software was employed.

The scientist found support for a significant moderating effect of PCB on the nexus between job satisfaction (JST) and OCB, such that PCB demoralised a satisfied physician in showing OCB. In contrast, a fulfilled psychological contract motivated satisfied physicians to exhibit OCB.

PCB, if not addressed, may lead satisfied physicians to show low OCB, which has devastating effects for health-care organisations and their patients. Creating balanced, fulfilled and harmonious relationship within physicians will transform the workplace into a more meaningful and purposeful atmosphere.

This study offers empirical health-care literature on the moderating effect of PCB, a psychosocial stressor, on the direct relationship between JST and OCB, integrating and lengthening the social exchange theory, resource-based theory and activation theory.

This paper aims to assess the influence of nursing leadership style on error management culture (EMC).

This scoping review was conducted following the integrative review methodology of the Joanna Briggs Institute (JBI) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). PubMed, CINAHL, Scopus, Web of Science, Embase and EBSCO databases were systematically searched to identify studies on nursing leadership, error management and measurement, and error management culture. The studies’ methodological quality was then assessed using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies.

Thirteen manuscripts were included for review. The analysis confirmed that nursing leadership plays an important role in EMC and nurses’ intention to report errors. Three emerging themes were identified: 1) leadership and EMC; 2) leadership and the intention to report errors; and 3) leadership and error rate.

A major limitation of the studies is that errors are often analyzed in a transversal way and associated with patient safety, and not as a single concept.

Healthcare managers should promote training dedicated to head nurses and their leadership style, for creating a good work environment in which nurses feel free and empowered to report errors, learn from them and prevent their reoccurrence in the future.

There is a positive relationship between nursing leadership and error management in terms of reduced errors and increased benefits. Positive nursing leadership leads to improvements in the caring quality.

This study aims to evaluate and compare the quality of work life (QWL) of nurses, in pre- and post-COVID-19 pandemic situations.

The study adopts a descriptive research design. Data were collected during the pre- and post-pandemic periods. The target sampling unit of the study comprises nurses working in Bangalore city, Karnataka, India. The minimum sample size was determined (Bartlett et al., 2001) as 385. The scale validation is carried out. The factors for the present study were explored using exploratory factor analysis and confirmed by confirmatory factor analysis. Model fitness (proposed measurement model) is ensured by using fit indices. The linear regression method was used to measure the level of QWL of nurses.

The present study noted that key factors that affects the QWL of nursing staff are work condition; work environment; work-life balance; compensation and reward; career development; job satisfaction and security; organization culture; relationship among co-workers and stress. Further, it is noticed that QWL of nurses pre-COVID-19 pandemic is 87.2%, while post-COVID-19 pandemic, it is 67%.

Present study can be extended to address the same research question by considering sampling unit such as therapist, technicians and sanitarians who have equally undergone tremendous pressure during pandemic.

The study outcome provides references for organizations engaged in health services to understand the extreme job conditions posed by pandemic. The constructive inspiration (physio-social and organizational support) reinforces the nurses to continue in their professions by decreasing negative impact.

The research paper extends the contributions of Hwang (2002), Nikeghbal et al. (2021), Howie–Esquivel et al. (2022) and Rania et al. (2023) and add to the existing body of the QWL literature. The outcome of the research records the prevailing conditions of pandemic and its effect on changes in work environment with specific reference to health-care sector.