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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.

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.

The various quality improvement (QI) frameworks and maturity models described in the health services literature consider some aspects of QI while excluding others. This paper aims to present a concerted attempt to create a quality improvement maturity model (QIMM) derived from holistic principles underlying the successful implementation of system-wide QI programmes.

A hybrid methodology involving a systematic review (Phase 1) of over 270 empirical research articles and books developed the basis for the proposed QIMM. It was followed by expert interviews to refine the core constructs and ground the proposed QIMM in contemporary QI practice (Phase 2). The experts included academics in two academic conferences and 59 QI managers from the New Zealand health-care system. In-depth interviews were conducted with QI managers to ascertain their views on the QIMM and its applicability in their respective health organisations (HOs).

The QIMM consists of four dimensions of organisational maturity, namely, strategic, process, supply chain and philosophical maturity. These dimensions progress through six stages, namely, identification, ad-hoc, formal, process-driven, optimised enterprise and finally a way of life. The application of the QIMM by the QI managers revealed that the scope of QI and the breadth of the principles adopted by the QI managers and their HOs in New Zealand is limited.

The importance of QI in health systems cannot be overstated. The proposed QIMM can help HOs diagnose their current state and provide a guide to action achieving a desirable state of quality improvement maturity. This QIMM avoids reliance on any single QI methodology. HOs – using the QIMM – should retain full control over the process of selecting any QI methodology or may even cherry-pick principles to suit their needs as long as they understand and appreciate the true nature and scope of quality overstated. The proposed QIMM can help HOs diagnose their current state and provide a guide to action achieving a desirable state of quality improvement maturity. This QIMM avoids reliance on any single QI methodology. HOs – using the QIMM – should retain full control over the process of selecting any QI methodology or may even cherry-pick principles to suit their needs as long as they understand and appreciate the true nature and scope of quality.

This paper contributes new knowledge by presenting a maturity model with an integrated set of quality principles for HOs and their extended supply networks.

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.

Child-to-Child (C-to-C) approach is an evidence-based approach that ensures the child’s participation in bringing about positive changes in healthcare. By systematically investigating the literature, the study aimed to evaluate the effectiveness of the approach and recognize associated themes, methodologies and outcomes.

An extensive search on PubMed, ProQuest, Cochrane and Dimensions AI databases was performed for original research articles on C-to-C intervention, with no time and geographical restrictions. Following PRISMA and PICO, the Joanna Briggs Institute (JBI) critical appraisal tool assessed the studies. A data tabulation technique was used to summarize these studies.

The approach shows promising results in enhancing children’s understanding of health issues and their participation in community health promotion. This, in turn, encourages the adoption of better healthcare practices and shows improved health outcomes.

Further research is required to understand the long-term impact of the approach on populations from diverse socioeconomic statuses in different study settings.

The findings will be helpful for practitioners, educators, policymakers and other stakeholders in creating more successful and effective C-to-C intervention programs to make informed decisions, achieve sustainable behavior change and improve health.

The originality of this review paper is evident in its unique focus on the C-to-C approach, which empowers children not only as recipients of health education but also as active contributors to promoting health. Further, the present research also explores the intricacies of how children learn from each other, offering new insights into effective educational practices.

Peer work would previously have been associated with having a lived experience of mental health conditions and working with people in a relatable way to model that context. However, peer support work has since embraced a wider composition from the generic context, seeing that ethnic minorities face many health, social and psychological challenges, especially those deemed Refugees/Asylum Seekers (International Protection Applicants) on their journey to resettlement in host countries. The Health Service Executive's Social Inclusion office plays a crucial role in responding to the health needs of service users from underserved communities. The health and care needs of people from diverse ethnic, cultural and religious communities fall within the remit of the Health Service Executive Social Inclusion office nationally. The context for peer work in ethnic minority communities is that it is a pilot programme evaluated and endorsed as a national programme by the National Intercultural Health Group. It is evidence-based and aligned with national strategy/policy, with training options available to peer support workers. In the Southeast region of Ireland, communities vulnerable to health inequality targeted by the Social Inclusion team would range from Roma to Refugees and International Protection Applicants – formally known as Asylum Seekers. This chapter will focus on these ethnic populations and how peer support work is delivered in these contexts.

This paper aims to describe the design and evaluation of a pilot leadership development programme for infection prevention and control (IPAC) professionals during the COVID-19 pandemic. The programme’s aim was to improve IPAC knowledge and capacity in the health-care system by developing the leadership skills and capacities of novice and advanced Infection Control Professionals (ICPs), to respond flexibly, and competently, in their expanding and ever-changing roles.

The leadership programme was piloted with seven nurses, who were part of a clinical nursing team in New South Wales, Australia, over a 12-month period between 2021 and 2022. The programme was designed using a leadership development framework underpinned by transformational leadership theory, practice development approaches and collaborative and experiential learning. These principles were applied during programme design, with components adapted to learners’ interests and regular opportunities provided for collaboration in active learning and critical reflection on workplace experiences.

The authors’ evaluation suggests that the programme was feasible, acceptable and considered to be effective by this cohort. Moreover, participants valued the opportunities to engage in active and experience-based learning with peers, and with the support of senior and experienced ICPs. The action learning sets were well-received and allowed participants to critically reflect on and learn from one another’s experiences. The mentoring programme allowed them to apply their developing leadership skills to real workplace challenges that they face.

Despite a small sample size, the authors’ results provide empirical evidence about the effectiveness of using a practice development approach for strengthening ICP leadership capacity. The success of this pilot study has paved the way for a bigger second cohort of participants in the programme, for which further evaluation will be conducted.

The success of this leadership programme reflects both the need for leadership development in the IPAC professions and the applicability of this approach, with appropriate facilitation, for other professions and organizations.

ICP leadership programmes have not been previously reported in the literature. This pilot study builds on the growing interest in IPAC leadership to foster health system responsiveness and change.

The purpose of this paper is to evaluate the impact of leadership development programmes, underpinned by Transformational Learning Theory (TLT).

A corpus-informed analysis was conducted using survey data from 690 participants. Data were collected from participants’ responses to the question “please tell us about the impact of your overall experience”, which culminated in a combined corpus of 75,053 words.

Findings identified patterns of language clustered around the following frequently used word types, namely, confidence; influence; self-awareness; insight; and impact.

This in-depth qualitative evaluation of participants’ feedback has provided insight into how TLT can be applied to develop future health-care leaders. The extent to which learning has had a transformational impact at the individual level, in relation to their perceived ability to influence, holds promise for the wider impact of this group in relation to policy, practice and the promotion of clinical excellence in the future. However, the latter can only be ascertained by undertaking further realist evaluation and longitudinal study to understand the mechanisms by which transformational learning occurs and is successfully translated to influence in practice.

Previous research has expounded traditional leadership theories to guide the practice of health-care leadership development. The paper goes some way to demonstrate the impact of using the principles of TLT within health-care leadership development programmes. The approach taken by The Florence Nightingale Foundation has the potential to generate confident leaders who may be instrumental in creating positive changes across various clinical environments.

The main purpose of this paper is to examine the status of poverty and its reduction by following the inclusive development approach. This study is designed to examine the benefits obtained from development programs, assess the government’s commitment to alleviating social inequality, and its impacts on the redistribution of wealth and poverty reduction.

To evaluate the implementation of the various development schemes and enhance grass-roots participation, a survey was carried out on 540 households, selected through multistage stratified sampling techniques in three different states of Punjab. The study employed an exploratory factor analysis on 21 independent variables to identify the key factors influencing poverty reduction subsequently followed by the binary logistic regression to access the sectoral impact of inclusiveness on poverty reduction in Punjab.

Exploratory Factor analysis extracted six key factors from the selected 21 variables, also called statements: “'Housing Development Resources”; “Human Capital Variables”; “Livelihood Essentials”, “Medical and Family Welfare Benefits”; “Receiving Educational Benefits”; and Social Security Benefits’. Binary logistic regression revealed that Housing Development Resources, Human Capital Variables, and Receiving Educational Facilities, significantly predict the likelihood of poverty reduction with inclusive growth in Punjab.

To provide basic amenities to rural people, increased people’s participation, decentralized planning, extended irrigation facilities, improved equipped facilities, and improved cultivation techniques are pivotal. The Indian Government has implemented several programs and projects to develop and support rural households. However, these schemes have faced many challenges such as rigidity, non-adaptability to local conditions, late disbursements of funds, reallocation of funds to unrelated expenditures by some states, embezzlement, and bribery demands. Hence, the findings indicate the presence of pseudo-inclusivity in Punjab’s growth.

The study’s uniqueness lies in its focus on selected districts of Punjab and also its application of exploratory factor analysis and binary logistic regression to construct a statistical model from the selected variables.

Greener on the Outside for Prisons (GOOP) is a therapeutic horticulture programme targeting the high levels of complex health and social care needs in prisons in England. The COVID-19 pandemic and resulting lockdowns led to unprecedented disruption in prisons in England. This paper examines the experiences of prisoners both during and post-lockdowns in four prisons, to understand the effects of participation in GOOP on health and wellbeing after the disruption of restrictions, and identify implications for developing this programme further.

The paper is based on original qualitative data gathered from in-depth narrative-based interviews and focus groups with prisoners and staff in four English prisons. Audio data was transcribed and subject to a thematic analysis, drawing from a realist-informed lens.

Thematic analysis revealed five key themes: reimagining the GOOP context; increasing empathy between participants; building sense of coherence; reconnecting with nature and a joined-up connection with provider services. The main arguments centre on horticulture in prisons remaining under-utilised as a means of promoting good health and wellbeing, although there is enthusiasm from staff to provide green spaces for the most vulnerable prisoners and develop a range of mechanisms to connect people in prison with nature.

This paper focuses on new knowledge arising from an unprecedented situation in English prisons, from key stakeholders on the frontline of garden activities. Accounts demonstrate the extent of the health and wellbeing benefits of participation in such activities in this challenging environment, which has implications for practice for prisons more widely.