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During the 1990s, Italian healthcare organisations (HOs) underwent a process of corporatisation, and the most innovative HOs introduced the balanced scorecard (BSC) to address the need for broader accountability. Currently, there is a limited understanding of the dynamics and outcomes of such a process. Therefore, this study aims to explore whether the BSC is still considered an effective performance management tool and analyse the factors driving and hindering its evolution and endurance in public and non-profit HOs.

We conducted a retrospective longitudinal analysis of two pioneering cases in the adoption of the BSC: one in a public hospital and the other in a non-profit hospital. Data collection relied on accessing institutional documents and reports from the early 2000s to the present, as well as conducting semi-structured interviews with the internal sponsors of the BSC.

We found evidence of three main categories of factors that trigger or hinder the adoption and development of the BSC: (1) the role of the internal sponsor and professionals’ commitment; (2) information technology and the controller’s technological skills; and (3) the relationship between the management and professionalism logics during the implementation process. At the same time, there is no evidence to suggest that specific technical features of the BSC influence its endurance.

The paper contributes to the debate on the key factors for implementing and sustaining multidimensional control systems in professional organisations. It emphasises the importance of knowledge-based assets and distinctive internal capabilities for the success of the business. The implications of the BSC legacy are discussed, along with future developments of multidimensional control tools aimed at supporting strategy execution.

Value-based healthcare suggested using patient-reported information to complement the information available in the medical records and administrative healthcare data to provide insights into patients' perceptions of satisfaction, experience and self-reported outcomes. However, little attention has been devoted to questions about factors fostering the use of patient-reported information to create value at the system level.

Action research design is carried out to elicit possible triggers using the case of patient-reported experience and outcome data for breast cancer women along their clinical pathway in the clinical breast network of Tuscany (Italy).

The case shows that communication and engagement of multi-stakeholder representation are needed for making information actionable in a multi-level, multispecialty care pathway organized in a clinical network; moreover, political and managerial support from higher level governance is a stimulus for legitimizing the use for quality improvement. At the organizational level, an external facilitator disclosing and discussing real-world uses of collected data is a trigger to link measures to action. Also, clinical champion(s) and clear goals are key success factors. Nonetheless, resource munificent and dedicated information support tools together with education and learning routines are enabling factors.

Current literature focuses on key factors that impact performance information use often considering unidimensional performance and internal sources of information. The use of patient/user-reported information is not yet well-studied especially in supporting quality improvement in multi-stakeholder governance. The work appears relevant for the implications it carries, especially for policymakers and public sector managers when confronting the gap in patient-reported measures for quality improvement.

The purpose of the paper is to showcase the significant achievements of Egypt's scientists in the 20th century across various fields of study such as medicine, physics, chemistry, biology, math, geology, astronomy and engineering. The paper highlights the struggles and successes of these scientists, as well as the cultural, social and political factors that influenced their lives and work. The aim is to inspire young people to pursue careers in science and make their own contributions to society by presenting these scientists as role models for hard work and dedication. Ultimately, the paper seeks to promote the importance of science and its impact on society.

The purpose of this review is to present the scientific biographies of Egypt's most distinguished scientists, primarily in the field of Natural Sciences, in a balanced and comprehensive manner. The work is objective, honest and abstract, avoiding any bias or exaggeration. The author provides a clear and concise methodology, including a brief introduction to the scientist and their field of study, an explanation of their major contributions, the impact of their work on society, any challenges or obstacles faced during their career and their lasting legacy. The aim is to showcase the important achievements of these scientists, their impact on their respective fields and to inspire future generations to pursue scientific careers.

The group of outstanding scientists in 20th century Egypt were shaped by various factors, including familial upbringing, education, society, political and cultural atmosphere and state support for scientific research. These scientists made significant contributions to various academic disciplines, including medicine, physics, chemistry, biology, mathematics and engineering. Their impact on their communities and cultures has received international acclaim, making them role models for future generations of scientists and researchers. The history of these scientists highlights the importance of educational investments and supporting scientific research to foster innovation and social progress. The encyclopedia serves as a useful tool for students, instructors and education professionals, preserving Egypt's scientific heritage and honouring the scientists' outstanding accomplishments.

The encyclopedia preserves Egypt's scientific heritage, which has been overlooked for political or other reasons. It is a useful tool for a variety of readers, including students, instructors and education professionals, and it offers insights into universally relevant scientific success factors as well as scientific research methodologies. The encyclopedia honours the outstanding scientific accomplishments of Egyptian researchers and their contributions to the world's scientific community.

The practical implications of this paper are several. First, it highlights the importance of education, family upbringing and societal support for scientific research in fostering innovation and social progress. Second, it underscores the need for continued funding and support for scientific research to maintain and build upon the accomplishments of past generations of scientists. Third, it encourages young people to pursue scientific careers and make their own contributions to society. Fourth, it preserves the scientific heritage of Egypt and honors the contributions of its outstanding scientists. Finally, it serves as a useful tool for students, instructors and education professionals seeking to understand the factors underlying scientific success and research methodologies.

The social implications of the paper include promoting national pride and cultural identity, raising awareness of the importance of education and scientific research in driving social progress, inspiring future generations of scientists and researchers, reducing socioeconomic disparities and emphasizing the role of society, politics and culture in shaping scientific researchers' personalities and interests.

The paper's originality/value lies in its comprehensive documentation of the scientific biographies of Egypt's most prominent scientists in the 20th century, providing unique insights into the factors that contributed to their development and their impact across various academic disciplines. It preserves Egypt's scientific heritage and inspires future generations of scientists and researchers through the promotion of educational investments and scientific research. The encyclopedia serves as a useful tool for education professionals seeking to understand scientific success factors and research methodologies, emphasizing the importance of supportive and inclusive environments for scientific development.

The lean startup approach (LSA) is extensively utilized by early-stage entrepreneurs, with “pivot” serving as a key pillar. However, there is a research gap concerning the boundary conditions impacting LSA and pivot decisions, especially when addressing societal challenges, as in the context of transformational entrepreneurship. In this regard, the healthcare sector, further compounded by a lack of research on startups and scale-ups, presents an embraced opportunity to provide multiple contributions for both theory and practice.

The present investigation employs a grounded approach to explore the experiences of the co-founders of a fast-growing Italian e-health startup. A narrative strategy was employed to organize conditions and evolving strategic action/interactions into three different pivoting phases of the startup – before the pivot, its enactment and aftermath – with primary and secondary data collected over a period of one year.

Pivoting in digital healthcare unfolded as a liminal experience marked by factors such as high regulation, multiple stakeholders, technological and symbolic ambivalence, resource-intensive demands and institutional actors acting as pathway pioneers, leading to an information overload and unforeseeable uncertainty to manage. These factors challenge entrepreneurs' ability to attain optimal distinctiveness, presenting the paradoxical need for vertical flexibility for scaling up.

By uniquely illuminating the sector’s constraints on entrepreneurial phenomena, this study provides a valuable guide for entrepreneurs and institutional actors in addressing societal challenges.

This study introduces a process model of transformational information crafting when pivoting, highlighting the role of entrepreneurs' transformational stance and platform-mediated solutions as engines behind strategies involving information breaking and transition, preceding knowledge-driven integration strategies.

The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.

The methodology entails the integration of service design (SD) and action research (AR) methodologies, characterized by iterative phases that systematically alternate between action and reflective processes, fostering cycles of change and learning. Within this framework, stakeholders are engaged through semi-structured interviews, while the existing and envisioned processes are delineated and represented using BPMN 2.0. These methodological steps emphasize the development of an autonomous, patient-centric web application alongside the implementation of an adaptable and patient-oriented scheduling system. Also, business processes simulation is employed to measure key performance indicators of processes and test for potential improvements. This method is implemented in the context of the CP addressing transient loss of consciousness (TLOC), within a publicly funded hospital setting.

The methodology integrating SD and AR enables the detection of pivotal bottlenecks within diagnostic CPs and proposes optimal corrective measures to ensure uninterrupted patient care, all the while advancing the digitalization of diagnostic CP management. This study contributes to theoretical discussions by emphasizing the criticality of process optimization, the transformative potential of digitalization in healthcare and the paramount importance of user-centric design principles, and offers valuable insights into healthcare management implications.

The study’s relevance lies in its ability to enhance healthcare practices without necessitating disruptive and resource-intensive process overhauls. This pragmatic approach aligns with the imperative for healthcare organizations to improve their operations efficiently and cost-effectively, making the study’s findings relevant.

Research has established the prevalence and relevance of moral injury in healthcare workers, though less attention has been paid to the different classes of potentially morally injurious events (PMIEs) experienced by this population and their impact. This exploratory study sought to examine the frequency of self- and other-generated PMIE classes and their associations with demographic characteristics and well-being outcomes among mental healthcare staff.

Secondary analysis of data drawn from two cross-sectional surveys of 267 frontline and leadership staff from mental healthcare settings in the UK was conducted. Responses on the Moral Injury Events Scale and the Short Professional Quality of Life Scale were extracted for analysis.

Betrayal by others was most frequently endorsed (61.8%), whilst self-transgressions were least frequently reported (25.5%). After controlling for the number of PMIE classes experienced, betrayal significantly predicted secondary traumatic stress (p = 0.01) and burnout (p = 0.04). Additionally, other transgressions significantly predicted secondary traumatic stress (p = 0.008). The predictive effects of self-transgressions on burnout, secondary traumatic stress and compassion satisfaction were all nonsignificant after controlling for the number of PMIE classes experienced.

Findings highlight differences in the frequency and impact of self and other PMIEs experienced by healthcare professionals. Reducing cumulative exposure to differential PMIE classes appears to be of critical importance to improving occupational well-being in this group.

To our knowledge, this study is the first to explore the associations between PMIE classes and occupational well-being in a mental healthcare population, inclusive of frontline and leadership staff.

This study aims to focus on the supply chain (SC) cost drivers of healthcare industries in the USA, as SC costs have increased 40% over the last decade. The second-most significant expense, the SC, accounts for 38% of total expenses in a typical hospital, while most other industries can operate within 10% of their operating cost. This makes healthcare centers supply-chain-sensitive organizations with limited facilities for high-quality healthcare services. As the cost drivers of healthcare SC are almost unknown to managers, their jobs become more complex.

Guided by pragmatism and positivism paradigms, a cross-sectional study has been designed using quantitative and deductive approaches. Both primary and secondary data were used. Primary data were collected from health centers across the country, and secondary data were from healthcare-related databases. This study examined the attributes that explain the most significant variation in each contributing factor. With multiple regression analysis for predicting cost and Student's t-tests for the significance of contributing factors, the authors of this study examined different theories, including the market-based view and five-forces, network and transaction cost analysis.

This study revealed that supply, materials and services represent the most significant expenses in primary care. Supply-chain cost breakdown results in four critical factors: facility, inventory, information and transportation.

This study examined the data from primary and secondary care institutions. Tertiary and quaternary care systems were not included. Although tertiary and quaternary care systems represent a small portion of the healthcare system, future research should address the supply chain costs of highly specialized organizations.

This study suggests methods that can help to improve supply chain operations in healthcare organizations worldwide.

This study presents an empirically proven methodology for testing the statistical significance of the primary factors contributing to healthcare supply chain costs. The results of this study may lead to positive policy changes to improve healthcare organizations' efficiency and increase access to high-quality healthcare.

As healthcare continues to become more expensive and complex, considering the voice of the patient in the design and operation of healthcare practices is important. Wound care and rural healthcare scenarios pose additional complexities for providers and patients. This study sought to identify key determinants of patient service quality in wound care.

Patients at the wound care/ostomy clinic (WOC) in a rural hospital were surveyed using the Kano model. The Kano model enables the categorization of quality attributes based on the attributes' contribution to the subject's overall satisfaction (and dissatisfaction). Chi-square goodness-of-fit testing, multinomial analysis and power analysis were then used to determine the Kano categories for each satisfaction-related attribute.

The analyses resulted in 14 one-dimensional attributes and 3 indeterminable attributes. For the one-dimensional attributes, customer satisfaction is directly proportional to the level of performance for that attribute. The one-dimensional attributes included providing correct care on the first, provision of necessary supplies for care, appropriately qualified medical staff and confidence in care provided by medical staff, among others. Understanding the attributes important to the patient drive patient-centered care, which improves positive patient outcomes and recovery. These attributes can then be used by healthcare professionals to design patient-centric processes and services. This research provides a framework for incorporating the voice of the patient into healthcare services.

While the research methodology can be used in other healthcare settings, the findings are not generalizable to other wound care clinics. This research was conducted in one small, rural hospital. In addition, the sample size was small due to the size of the wound clinic; therefore, an analysis of the differences between demographics could not be performed.

Considering the perspectives of rural wound care patients is important, as the patients are an under-served population with unique challenges related to patient care. The research findings detail rural patients' expectations during wound care treatments, which enable the clinic to focus on improving patient satisfaction. This research contributes to understanding the factors that are important to patient satisfaction in wound care. Further, the methodology presented can be applied to other healthcare settings.

While studies exist using the Kano model in healthcare and the literature is sparse in rural healthcare, this is the first case study using the Kano model in wound care to understand patient preferences.

Healthcare providers are under pressure due to increasing and more complex demands for services. Increased pressure on budgets and human resources adds to an ever-growing problem set. Competent leaders are in demand to ensure effective and well-performing healthcare organisations that deliver balanced results and high-quality services. Researchers have made significant efforts to identify and define determining competencies for healthcare leadership. Broad terms such as competence are, however, inherently at risk of becoming too generic to add analytical value. The purpose of this study is to suggest a holistic framework for understanding healthcare leadership competence, that can be crucial for operationalising important healthcare leadership competencies for researchers, decision-makers as well as practitioners.

In the present study, a critical interpretive synthesis (CIS) was conducted to analyse competency descriptions for healthcare leaders. The descriptions were retrieved from peer reviewed empirical studies published between 2010 and 2022 that aimed to identify healthcare services leadership competencies. Grounded theory was utilised to code the data and inductively develop new categories of healthcare leadership competencies. The categorisation was then analysed to suggest a holistic framework for healthcare leadership competence.

Forty-one papers were included in the review. Coding and analysing the competence descriptions resulted in 12 healthcare leadership competence categories: (1) character, (2) interpersonal relations, (3) leadership, (4) professionalism, (5) soft HRM, (6) management, (7) organisational knowledge, (8) technology, (9) knowledge of the healthcare environment, (10) change and innovation, (11) knowledge transformation and (12) boundary spanning. Based on this result, a holistic framework for understanding and analysing healthcare services leadership competencies was suggested. This framework suggests that the 12 categories of healthcare leadership competencies include a range of knowledge, skills and abilities that can be understood across the dimension personal – and technical, and organisational internal and – external competencies.

This literature review was conducted with the results of searching only two electronic databases. Because of this, there is a chance that there exist empirical studies that could have added to the development of the competence categories or could have contradicted some of the descriptions used in this analysis that were assessed as quite harmonised. A CIS also opens for a broader search, including the grey literature, books, policy documents and so on, but this study was limited to peer-reviewed empirical studies. This limitation could also have affected the result, as complex phenomenon such as competence might have been disclosed in greater details in, for example, books.

The holistic framework for healthcare leadership competences offers a common understanding of a “fuzzy” concept such as competence and can be used to identify specific competency needs in healthcare organisations, to develop strategic competency plans and educational programmes for healthcare leaders.

This study reveals a lack of consensus regarding the use and understanding of the concept of competence, and that key competencies addressed in the included papers are described vastly different in terms of what knowledge, skills and abilities they entail. This challenges the operationalisation of healthcare services leadership competencies. The proposed framework for healthcare services leadership competencies offers a common understanding of work-related competencies and a possibility to analyse key leadership competencies based on a holistic framework.

Health-care marketing typically entails a coordinated set of outreach and communications designed to attract consumers (patients in the health-care context) who require services for a better health outcome and guide them throughout their health-care journey to achieve a higher quality of life. The purpose of this study is to understand the progress and trends in healthcare marketing strategy (HMS) literature between 2018 and 2022, with a special emphasis on the pre- and post-Covid-19 periods.

The authors examine 885 HMS-related documents from the WOS database between 2018 and 2022 that were extracted using a keyword-based search strategy. After that, the authors present the descriptive statistics related to the corpus. Finally, the authors use author co-citation analysis (ACA) and bibliographic coupling (BC) techniques to examine the corpus.

The authors present the descriptive statistics as research themes, emerging sub-research areas, leading journals, organisations, funding agencies and nations. Further, the bibliometric analysis reveals the existence of five thematic clusters: Cluster 1: macroeconomic and demographic determinants of healthcare service delivery; Cluster 2: strategies in healthcare marketing; Cluster 3: socioeconomics in healthcare service delivery; Cluster 4: data analytics and healthcare service delivery; Cluster 5: healthcare product and process innovations.

This study provides an in-depth analysis of the advancements made in HMS-related research between 2018 and 2022. In addition, this study describes the evolution of research in this field from before to after the Covid-19 pandemic. The findings of this study have both research and practical significance.

To the best of the authors’ knowledge, this is the first study of its kind to use bibliometric analysis to identify advancements and trends in HMS-related research and to examine the pattern before and after Covid-19 pandemic.