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The purpose of the study is to investigate the influence of direct-to-consumer advertising (DTCA) on consumers’ decision-making (CDM).

Practical data were used in the empirical analysis collected from 484 consumer surveyed by means of a questionnaire. Statistical techniques such as descriptive statistics, correlation, simple and multiple regressions were employed. A Cronbach’s alpha was used to confirm the suitability of the data collection instrument.

The results of the study indicated a positive significant relationship between DTCA and CDM. The results indicated that there was significant impact of healthcare awareness on CDM, but there were no significant impacts of drug–drug interactions, medical information source and consumer economical situation on CDM.

The data are also limited to a Jordanian market; therefore, generalizing results of a Jordanian setting to other countries may be questionable. Extending the analyses to other settings represent future research opportunities.

The current research may be considered as an initiative study that highlights the effect of DTCA on CDM in Jordan and in the Arab world. The results can provide the reference for further research about the relationship between DTCA and CDM.

The purpose of this research study was to obtain healthcare executives’ perspectives on diversity in executive healthcare leadership. The study focused on identifying perspectives about diversity and its potential impact on the access of healthcare services by people of color. The study also identified perspectives about factors that influence the attainment of executive healthcare roles by people of color.

A convenience sample of healthcare executives was obtained. The executives identified themselves as belonging to one of two subgroups, White healthcare executives or executives of color. Participants were interviewed telephonically in a semi-structured format. The interviews were transcribed and entered into a qualitative software application. The data were codified and important themes were identified.

The majority of the study participants perceive that diversity of the executive healthcare leadership team is important. There were differences in perspective among the subgroups as it relates to solutions to improve access to healthcare by people of color. There were also differences in perspective among the subgroups, as it relates to explaining the underrepresentation of people of color in executive healthcare leadership roles.

This research effort benefited from the subject matter expertise of 24 healthcare executives from two states. Expansion of the number of survey participants and broadening the geographical spread of where participants were located may have yielded more convergence and/or more divergence in perspectives about key topics.

The findings from this research study serve to add to the existing body of literature on diversity in executive healthcare leadership. The findings expand on the importance of key elements in contemporary literature such as diversity, cultural competency and perspectives about the need for representation of people of color in leadership roles that guide healthcare policy and access. This study connects contemporary literature to perspectives of executives in the field and offers practical solutions to improving the representation of people of color in executive healthcare leadership roles.

The recommendations offered as a result of this research effort serve to create awareness of the challenges that people of color face in career attainment. Although the process of increasing the representation of people of color in executive healthcare leadership will be a complex task that will involve a number of players over the course of several years, this study serves to provide a practical roadmap with actionable tactics that can be deployed.

This paper is an extension of the work that was done by the author during the course of completing the program requirements for the author’s doctoral program. The findings were previously discussed in the author’s dissertation. The value of these findings is significant because they validate some of the topics in contemporary literature with the perspectives of practicing healthcare executives. This study is also unique from other studies in that it offers a long-term plan to increase the representation of people of color in executive roles by creating an early disposition toward executive level roles and identifies a number of practical steps toward that end.

The purpose of this study is to identify organisational homeostasis factors in the context of healthcare organisations and to develop a conceptual model for green transformation.

The organisational homeostasis factors were determined by review of literature study and the opinions of healthcare experts. Scheduled interviews and closed-ended questionnaires are employed to collect data for this research. This study employed “TISM methodology” and “MICMAC analysis” to better comprehend how the components interact with one another and prioritise them based on their driving and dependence power.

This study identified 10 factors of organisational homeostasis in healthcare organisation. Recognition of interdependence, hormesis, strategic coalignment, consciousness on dependence of healthcare resources and cybernetic principle of regulations are the driving or key factors of this study.

The study's primary focus was on the organisational homeostasis factors in healthcare organisations. The methodological approach and structural model are used in a healthcare organisation; in the future, these approaches can be applied to other industries as well.

The key drivers of organisational homeostasis and the identified factors will be better comprehended and understood by academic and important stakeholders in healthcare organisations. Prioritizing the factors helps the policymakers to comprehend the organisational homeostasis for green transformation in healthcare.

In this study, the TISM and MICMAC analysis for healthcare is proposed as an innovative approach to address the organisational homeostasis concept in the context of green transformation in healthcare organisations.

Environmental sustainability in health care is an important issue due to the limited available healthcare resources and increase in demand. For instance, organ recycling and transplantation may reduce the increasing pressure on healthcare resources. The purpose of this paper is to set out to identify and interrelate the inhibitors that significantly influence the recycling of human organs and their implications to the environment in developing economies such as India.

The study uses Delphi–ISM–regression, a three-step method, to investigate the possible reasons for the poor supply chain efficiency of organ recycling and to explore the consequence of excessive use of healthcare resources on the environment. The Delphi technique facilitates the identification, synthesis, and prioritization of the inhibitors. Then, using focused group discussion, the interpretive structure modeling (ISM) presents the interaction among the inhibitors into a hierarchy. Further, on the basis of 257 valid responses received on the structured survey instrument, the regression model examines the influence of identified constructs on one of the identified root causes.

The ISM presents the hierarchy-based model that depicts high driving power and low dependence inhibitors leading to reduced organ recycling rate. “Negative Intentions of family members” toward organ donation t “Willingness to discuss with family” and “Perceived Behavioral Control” emerged as the significant factors influencing organ recycling rate, which adversely impact the environment sustainability.

The patients on the organ waiting list put pressure on the availability of medical resources and, ultimately, on the environment through the consumption of different drugs and disposable of medical wastes. The study suggests policymakers and hospitals improve on the existing policies for an efficient supply chain of human organ recycling. The Indian situation echoes the situation in most of the emerging economies, and similar solutions can apply there too.

This study intends to improve the quality of venous thromboembolism (VTE) prophylaxis practices including proper VTE risk assessment and the appropriate prophylaxis measures for surgical urology patients.

The authors applied the Six-Sigma define, measure, analyze, improve and control (DMAIC) improvement methodology in a pre–post interventional study that involved all adult patients above 18 years old indicated and scheduled for urology surgical interventions including endoscopic urological surgeries in a urology specialized 60-bed hospital. The pre-intervention sample included all patients meeting the inclusion criteria over a period of six months. Post-intervention sample included all patients meeting the inclusion criteria over a period of six months. The improvement areas included both the VTE risk assessment as well as the VTE prophylaxis prescription.

DMAIC methodology has achieved a substantial sustained improvement in surgical urology VTE prophylaxis practices with an average of 70% on both levels; VTE risk assessment practices and VTE prophylaxis prescribing practices were statistically significant. The post-intervention results also showed a statistically controlled process with no special cause variations. Based on the study results, the Six-Sigma DMAIC methodology can be considered of high value when applied in healthcare clinical practice improvement projects.

The project study includes some pitfalls that can be addressed as follows: 1. The lack of VTE rate incidence tracking. This limitation can be partly refuted when the authors conduct a literature review and explore that the VTE prophylaxis effectiveness had been proven with sufficient evidence to an extent that pushed several scientific societies to develop their own guidelines to support VTE prophylaxis. (Algattas et al., 2018). 2. Another limitation of this study can be that it handled only surgical patients and more specifically surgical urology patients. Of course, VTE prophylaxis is a crucial life-threatening problem not only for the surgical admitted patients but also for all the medical admitted patients either in hospital wards or ICUs. However, the prediction that surgical patients especially surgical urology patients are more prone to VTE development risk as they have -in several cases-two or three main additive risk factors which are age, procedure duration and malignancy in elderly men. (Tikkinen et al., 2014). So, the authors consider the study project to be a prototype that hopefully can be utilized for future study projects that will manage both other surgical specialty patients and medical patients on the national level and can track accurately and effectively report the VTE incidence rates.

Several recommendations can be extracted from the research project that is summarized in the following points: Paying focused attention to continuous healthcare quality improvement initiatives and projects as a main approach for healthcare improvement especially for the public health-related problems. This might be achieved through periodic region-specific or specialty-specific focus groups from which public health problems could be addressed and prioritized to be considered as a part of country healthcare campaigns regarding cost-utility and feasibility studies. The adoption of a system thinking approach in dealing with the improvement strategies; all efforts and resources are to be employed to achieve a common objective. This includes the generation of a national-wide electronic health information system that can aid in healthcare resource allocation and direct the healthcare efforts towards the most important, high-priority public health problems. Electronic national-wide health record is really an effort, and resources consuming activity, but actually, it's worth exerting efforts, and its valuable outcomes may be seen several years later. 3. Development of unified national specialized VTE prophylaxis pathways to standardize the patient-specific VTE prophylaxis plans. Standardization of healthcare pathways enables healthcare professionals to follow an evidence-based practice which will be reflected on the improvement of healthcare quality level, cost-effectiveness enhancement, and timely patient care on all levels especially in high critical areas like ER and ICU. 4. Incorporation of VTE prophylaxis costs in the universal health insurance diagnosis-related group (DRG) insurance packages and service pricing. Universal health insurance is a nationwide strategy that is aiming to cover all Egypt residents by the year 2030. Universal health insurance is being following the DRG reimbursement policy that is thought to control all the healthcare-associated costs so, the VTE prophylaxis costs shall be added as the main cost item to encourage all healthcare facilities to follow an evidence-based VTE prophylaxis pathway taking into consideration the high-risk patient categories who will definitely represent a high-cost burden on the long run if they suffer a VTE event.

DMAIC improvement methodology applications in healthcare are still relatively limited, especially on the clinical level. The study can be considered one of a kind in Egypt dealing with a comprehensive DMAIC methodology application on the clinical level.

This study aims to offer a literature review on microinsurance, focusing on its financial performance and social impact. The aim is to review current research in microinsurance performance. Over the past decade, microinsurance has aroused the interest of the scientific community. Scholars have monitored its development and have examined its impact on the poor’s ability of breaking out of the poverty trap.

A systematic-narrative method was used to review the relevant literature. In total, 64 relevant articles on investigating the financial performance and the effects of microinsurance programs on the poor’s well-being were reviewed, coded and followed by a narrative synthesis.

This review synthesizes current published data on microinsurance to provide practitioners and researchers with a better understanding of this important area. Microinsurance benefits the poor, as it reduces their vulnerability to poverty. Microinsurance has a twofold impact on an individual’s ability to overcome poverty. First, it has a direct impact on access to healthcare services and, second, it has an indirect effect on an individual’s economic status, by moderating risk vulnerability and improving income stability. Further research is necessary to reach concrete conclusions about the financial performance of microinsurance programs. Finally, the analysis of the literature revealed an absence of research regarding the impact of microinsurance on society and sustainable development.

An understanding of the performance of microinsurance services is important. Therefore, the findings can be used by microinsurance practitioners to assess and improve their performance. Further, policy implications such as improvement of financial knowledge and social marketing via education polices to increase microinsurance awareness of its benefits are recommended.

This review provides a synthesis of the literature in microinsurance concerning its financial and social performance, and raises suggestions for future research.

Using total interpretive structural modelling (TISM), this paper aims to “identify”, “analyse” and “categorise” the sustainable-resilience readiness factors for healthcare during the Covid-19 pandemic.

To obtain the data, a closed-ended questionnaire was used in addition to a scheduled interview with each respondent. To identify how the factors interact, the TISM approach was employed and the cross-impact matrix multiplication applied to a classification method was used to rank and categorise the sustainable-resilience readiness factors.

This study identified ten sustainable-resilience readiness factors for healthcare during the Covid-19 pandemic. The study states that the major factors are environmental scanning, awareness and preparedness, team empowerment and working, transparent communication system, learning culture, ability to respond and monitor, organisational culture, resilience engineering, personal and professional resources and technology capability.

The study focused primarily on sustainable-resilience readiness characteristics for the healthcare sector.

This research will aid key stakeholders and academics in better understanding the factors that contribute to sustainable-resilience in healthcare.

This study proposes the TISM technique for healthcare, which is a novel attempt in the subject of readiness for sustainable-resilience in this sector. The paper proposes a framework including a mixture of factors for sustainability and resilience in the healthcare sector for operations.

The occurrence of fire accidents in hospital buildings has become a serious challenge and more serious in developing nations. The purpose of this paper intends to assess fire safety measures in Nigerian hospital facilities. The significance of this study is to ensure that the design and construction of hospital facilities enhance the safety of users and properties.

The data were collected via a case study and questionnaire survey and administered to the facility users. The study survey is to assess the respondents' perception of fire safety measures in hospital facilities and suggest possible policy measures that will be employed to enhance safety.

This paper found that 91% of the respondents have awareness of fire safety measures in hospital facilities. Electrical faults and combustible materials were identified as the frequent causes of fire occurrences in hospital facilities. This can be averted where flammable materials and electrical appliances are correctly installed, and safety rules enforced. Findings show that safety rules are lax in public than standard private hospitals.

This paper is limited to fire safety measures in Nigerian healthcare facilities. Future research is needed to evaluate the level of compliance from design, construction and post-construction of precautionary fire safety measures in hospital facilities in Nigeria.

This paper recommended that designers and hospital administrators should improve on fire safety measures via the development of fire safety management plan and education. Thus, enforcement of fire safety measures in hospital facilities as specified in building codes should be implemented and monitored during and after the design of the hospital buildings. Findings provide valuable lessons on how to improve the fire safety measures in healthcare facilities across the states and other developing countries with similar healthcare situations.

This paper demonstrates that the stakeholders, especially government agencies concern with approval and enforcement of fire safety measures in healthcare facilities need to reawaken to her responsibility because of the lax implementation across the states.

Inequalities can have a cumulative effect that leads to the presentation and subsequent progression of mental health difficulties. The detrimental effects can be compounded in the healthcare environment if staff lack an awareness of patients’' inequalities, and therefore, educating staff is of particular importance. The development of awareness training requires a deep understanding of staff perceptions of patient inequalities in a secure mental health care setting and the impact that this can have on mental illness.

The study was carried out using a qualitative design, where staff were asked to complete a 22-question survey from which the output is analysed using thematic analysis. In total, 100 patient-facing staff members working in a secure mental health facility completed the survey.

The results highlight that staff employed in a secure mental health care setting have an understanding of patient inequalities and how these can impact on patients in both the short and longer terms. The results highlighted the importance of awareness by staff and how an increase can have a significant benefit on the quality of the care provided within secure mental health facilities.

There is an increasing awareness of the impact of inequalities on mental health and how this can influence a patient’s journey. This study involving staff employed in a secure care mental health facility highlights the role of staff awareness of inequalities and also underlines the importance of understanding the key role of staff awareness in mental ill health.

A qualitative study can help in understanding the unpolluted perspectives of key stakeholders involved in the vaccination practices and can explore vital factors that could influence vaccination-related behaviors and their utilization. This study aims to document the perceptions of caretakers, community members and healthcare service providers related to childhood vaccination practices in slums under the national immunization program (NIP) of India.

This was a qualitative community-based cross-sectional study. Focus group discussions with caretakers, community members and healthcare service providers were used to build a holistic, detailed description and analysis of the factors associated with childhood vaccination practices within its real-world context.

Lack of awareness, fear of adverse events following immunization, inappropriate timing of vaccination sessions, loss of daily earnings, migration, lack of good behavior of health staffs, shortage of logistics and vaccines, limited resources and infrastructures and high expectations of beneficiaries were some of the vital barriers impacting vaccination practices in slums.

Though this study provides significant good information on the indicators that can be considered to improve the vaccination practices in any slum settings, it has is also a limitations too due to its setting. Therefore, one needs to be cautious while generalizing these results to other settings like rural. In addition, Though we believe that these strategies could be useful in any setting, it is also important to tailor these observations them as per the need of the society and the population. Also, this is a self-reported qualitative study and therefore the perspectives reported in this study need to be taken with caution. Further, low vaccination, poor awareness, compromised healthcare services, high expectations could be considered as a stigma/fear among the responders and therefore there is always a chance of underreporting. Thus, it would be important in future to conduct a study involving a broader group of people in society and to establish factors associated with the vaccination coverage. that can help in improvement of vaccination.

Initiatives such as regular interactions at different levels, effective communication including reminders, behavior interventions, the continued supply of vaccines and logistics, additional resources for the vaccination program, incentives and recognition, extended sessions and people-friendly healthcare delivery system could be helpful to strengthen the routine vaccination practices in slums.