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The purpose of this paper is to explore stakeholder expectations of performance within public healthcare services from a less-developed economic context – Zambia in this case. The study emerges from extant literature indicating potential variations in stakeholder conceptions and expectations of performance within public services.

The paper draws on institutional and structuration theories to investigate cross-sectional stakeholder expectations of performance together with power relations embedded within public healthcare performance expectations. Empirical data are drawn from semi-structured interviews with 33 stakeholders including legislators, policymakers, regulators of health services, healthcare professionals and health facility managers.

The findings not only reiterate the constructed and multi-dimensional nature of performance but also highlight the hierarchical configuration of stakeholder expectations linking macro-level health outcomes with micro facility-level service delivery processes.

The study points towards the need of harmonising the national performance measurement (PM) framework to ensure that macro-level goals are suitably cascaded and translated into micro-level service delivery processes through bottom-up structuration linkages.

In addition to filling the gap of explicating public healthcare PM practices in a less-developed economic context, the paper integrates insights from institutional and structuration theories to depict stakeholder expectations of performance through a multi-level and hierarchical framework.

Research findings provide the professional community with knowledge that enables to better understand healthcare interventions. Many authors point out that whilst these findings are valued, the findings are not always translated into healthcare practise. The purpose of the paper is to assess the applicability of the essential elements of an integrated palliative care system (IPCS) found in research into the practise of Osona Palliative Care System (OPCS).

The study used a qualitative methodology with a case study design. In total, 24 health professionals were interviewed in Osona for the research, and the results were analysed using deductive content analysis.

The study concludes that research findings can better be translated into specific contexts by incorporating the needs and characteristics of the system. The process could be a strategy for bridging the research–practise gap.

Combining the findings from the study and the findings found in the literature reviewed led to the creation of the IPCS-elements-blended model of research and practise. Such a kind of mixed model could be used in other studies seeking to overcome the research and practice gap.

Shanghai is currently faced with a rapid increase in the ageing population and demand for elderly homes. Continuing care retirement community (CCRC) has been emerging as a high-end alternative to offer specialised accommodation to the elderly in major cities. Since the first development in 2008, the industry is now still at the infancy stage. This study aims to examine the investment barriers hindering the supply and demand of CCRCs with an aim to recommend practical and senior housing policy measures to facilitate CCRC developments.

Multiple-case study method was used to confirm whether the literature findings on investment barriers apply to the context of Shanghai. Four representative CCRC development cases in Shanghai were examined, in which qualitative data were collected from interviews with experienced CCRC development managers and quantitative data from a questionnaire survey of the CCRC residents.

Operation management experience, financial risks and government support policy were found to be the main supply barriers. Chinese traditional family-oriented culture and affordability were not the main demand barriers of CCRCs in Shanghai. Poor quality of services and living environment were identified as the main barriers suppressing the demand for CCRC.

Although common trends and views can be drawn from the representative cases in Shanghai to provide valid results, further research should be conducted on other major cities in China so that the results can be widely applied.

Successful CCRC investment strategy should focus on partnering with experienced professional eldercare management companies, provisions of high-quality medical professionals and trained care personnel and delivery of flexible care service, along with intensive capital flows for land, construction and operating costs.

Additional senior housing policy support should be established to promote the CCRC supply to address the ageing needs, particularly granting lands for CCRC developments at Tiers 1 and 2 major cities where the land cost is high.

This research’s practical and policy measures can be applied to enable and promote CCRC developments in Shanghai, thus benefitting both housing investors and the government. The findings also form a baseline for CCRC developments in other major cities.

Suicide is a tragic cause of death and causes considerable distress for families, carers and healthcare professionals. Thankfully, suicide rates in older people in the UK have steadily declined for both men and women since the mid‐1980s. An understanding of the clinical and demographic characteristics of both completed suicide and non‐fatal self‐harm in older people is important in informing the development of preventative strategies to sustain this decline. Non‐fatal self‐harm in older people is relatively uncommon compared with younger age groups, but research indicates that self‐harm among older people is frequently a failed attempt at suicide. Thus, the important factors associated with self‐harm in this age group are similar to those linked with completed suicide, particularly high rates of clinical depression, poor physical health and social isolation. Unfortunately, there is also a high rate of subsequent completed suicide. For this reason, self‐harm in later life needs to be taken very seriously and a careful assessment of risk and need by a specialist in older people's mental health should be conducted. The identification and appropriate management of older people with depression in the community and general hospitals is a key area for the prevention of self‐harm and suicide in this age group and requires further attention, particularly with targeted support programmes for those at high risk.

The aim of the project was to evaluate the short‐term treatment outcomes of patients treated in a medium secure service for people with intellectual disability. A total of 138 patients, 77 discharged and 61 current inpatients, treated over a six‐year period were included in the audit. Information on demographic and clinical variables was collected on a pre‐designed data collection tool and analysed using appropriate statistical methods. The median length of stay for the discharged group was 2.8 years. About 90% of this group were discharged to lower levels of security and about a third went directly to community placements. None of the clinical and forensic factors examined was significantly associated with length of stay for this group. There was a ‘difficult to discharge long‐stay’ group which had more patients with criminal sections, restriction orders, history of abuse, fire setting, personality disorders and substance misuse. However, when regression analysis was done, most of these factors were not predictive of the length of stay. Clinical diagnosis or offending behaviour categories are poor predictors of length of hospital stay, and there is a need to identify empirically derived patient clusters using a variety of clinical and forensic variables. Common datasets and multi‐centre audits are needed to drive this.

Despite the prevalent use of professional status and service feedback in online healthcare markets, the potential interaction relationship between two types of information is still unknown. This study used the signaling theory to examine the substitute relationship between professional status and service feedback in patients' doctor choice, as well as the moderating effect of illness severity.

To test the paper's hypotheses, we constructed a panel data model using 418 doctors' data collected over a period of six months from an online healthcare market in China. Then, according to the results of the Hausman test, we estimated a fixed-effects model of patients' choice in online healthcare markets.

The empirical results showed that the effect of a doctor's professional status and service feedback on a patient's doctor choice was substitutable. Moreover, patients' illness severity played a moderating role, in that the influence of professional status on a patient with high-severity illness was higher than that on a patient with low-severity illness, whereas the influence of service feedback on a patient with low-severity illness was higher than that of a patient with high-severity illness. In addition, we found that illness severity negatively moderated the substitute relationship between professional status and service feedback on a patient's choice.

These findings not only contribute to signaling theory and research on online healthcare markets, but also help us understand the importance of professional status and service feedback on a patient's choice when seeking a doctor online.

Social media has made a revolutionary change in the relationship between the customers and business or service providers by enabling customers to publish and share feedback and views about product or service quality. This revolutionary change has not been echoed in some healthcare systems. This study analyses the social media policies of healthcare regulatory authorities in Ontario and explores how these policies encourage or discourage healthcare professionals' use of social media for collecting patient stories and understanding patient experience.

The study used qualitative content analysis to analyse the policy documents, focusing on the manifest themes in these documents. It used convenient sampling to select 12 organizations, including regulating and licensing bodies and health service delivery organizations in Ontario. The authors collected 24 documents from these organizations, including policies, practice standards and social media learning materials.

In Ontario's healthcare system, social media is perceived as a source of risks to the healthcare professions and professionals. Healthcare regulators emphasize that the codes of conduct and professional standards extend to social media. The study found no systematic recognition of patient stories on social media as a source of information on healthcare quality that can be useful for healthcare professionals.

The study identifies potential unintended consequences of social media policies in the healthcare system and calls for policy and cultural changes to enable the development of safe social media platforms that can facilitate interaction between healthcare providers and patients, when necessary, without the fear of legal consequences or privacy breaches.

The purpose of this study is to explore how healthcare professionals in Denmark perceived and enacted their role as diabetes trainers for Arabic-speaking immigrants in three new local authority settings. The paper used positioning theory, which is a dynamic alternative to the more static concept of role in that it seeks to capture the variable, situationally specific, multiple and shifting character of social interaction, as the analytical tool to examine how people situationally produce and explain behaviour of themselves and others.

The paper generated data through observation of diabetes training and of introductory interviews with training participants in three local authority healthcare centres over a total of five months. The authors conducted 12 individual interviews and two group interviews with healthcare professionals.

Healthcare professionals shifted between three positionings – caregiver, educator and expert. The caregiver was dominant in professionals’ ideals but less in their practice. Healthcare professionals other-positioned participants correspondingly as: vulnerable, difficult students and chronically ill. The two first other-positionings drew on dominant images of an ethnic other as different and problematic.

Becoming more reflexive and explicit about one's positionings offer the potential for a more conscious, confident, flexible and open-ended teaching practice. Such reflexivity may also reduce the perception that teaching challenges are rooted in participants’ ethnic background.

The paper provides a new understanding of healthcare practice by showing professionals’ multiple and reciprocal positionings and the potential and risks in this regard. The paper demonstrates the need for healthcare workers to reflect on their positionings not only in relation to immigrants, but to all patients.