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The public healthcare system faces challenges and limitations regarding the supply and delivery of healthcare services. The private healthcare system is expensive and only affordable for some. Due to the increasing population, developing countries face a greater degree of demand–supply mismatch. The existing healthcare services in developing countries need to be more sustainable due to high out-of-pocket expenditures and low-income levels. The research design used in this chapter is a case study approach based on qualitative data. The study focuses on two objectives: (1) to have a detailed understanding of the nature of healthcare cooperatives in Spain and their contribution to meeting healthcare requirements; and (2) to make suggestions and recommendations for an improved and sustainable healthcare cooperative for developing countries. Inspired by the healthcare cooperative model of Spain and keeping in mind the ground reality of the lack of healthcare facilities and services accessible and affordable in developing countries, the authors have developed a conceptual framework with the foundation of an insurance cooperative. The Spain Model is sustainable for developing countries as it serves the interest of all income brackets, not leaving the low-income population behind. Concepts like cooperative worker insurance embedded in the model can ensure that the beneficiaries receive timely and good quality health services at an affordable price. It empowers individuals by allowing them to make small amounts of investments as premiums to secure a hopeful future for a healthy life.

The purpose of this paper is to review the causes of long waiting time in Hong Kong public hospitals and to suggest solutions in the service, organisational, systems, financial and policy perspectives.

The paper is a review of waiting time of public hospital services. Total joint replacement, which is one of the elective surgeries in public hospitals, is presented as a case study.

The average waiting time of semi-urgent and non-urgent patients in the accident and emergency departments of public hospitals is two hours, and that of specialist outpatient (SOP) clinics is from 1 to 144 weeks. For total joint replacement, it is from 36 to 110 months. Measures like Government subsidisation programme for the replacement surgery and employing adequate physiotherapists, Chinese medicine practitioners, clinical psychologists and nurses to reduce the waiting time are suggested. Issues concerning the healthcare system of Hong Kong, such as structural reform, service delivery model, primary care, quality and process management, and policy reviews, are also discussed.

The ‬over-reliance of public services has resulted in long waiting time in public hospitals in Hong Kong, particularly in the emergency services and SOP clinics. However, the consequences of long waiting period for surgical operations, though much less discussed by the media and public, can be potentially detrimental to the patients and families, and may result in more burdens to the already stretched public hospitals‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬.

Using multiple theoretical lenses, the paper develops and empirically tests a service design-based framework of effective customer participation (CP) in service delivery. Particularly, the paper examines the impact of customer education on effective CP, besides the latter's effect on service quality. The direct and moderating effect of service modularity on the association between customer education and effective CP is also studied.

Covariance-based structural equation modeling is used to test the hypotheses using the survey data collected from the healthcare industry within Pakistan.

The results lend support for the presence of individual and mutually reinforcing effects of customer education and service modularity on effective CP in service delivery, ultimately affecting service quality.

Building on the CP and customer learning literature, this research extends the work on antecedents and consequences of effective CP in the larger domain of the service design and service delivery literature.

The findings reveal that service managers should design services such that by design, CP is ingrained within service delivery processes so that it is effectively managed during service delivery for superior service quality.

Given the already scant research that has either taken a narrower view of CP (mostly in pre- or post-service delivery), the current research makes one of the initial attempts to identify, theorize and empirically test the service design level antecedents for holistic CP spanning over the physical, behavioral and informational participation during the service delivery.

The purpose of this paper is to define a new conceptual framework or model, to measure and manage organizational performance, both financial/non-financial and intellectual capital (IC), in a healthcare organization.

The integrated new model is produced by integrating the common assessment framework (CAF) model with two other frameworks representing the IC and leadership. These already existing models are originated, respectively by the Health Agency of Emilia-Romagna Region (Italy) and the National Healthcare System (NHS – UK). The integration phase is operated by comparing the CAF and IC models so as to assess the determinant factors that are present in both frameworks and eliminating such redundancies. Concerning the leadership determinant factor, the relevant conceptual framework of CAF model is substituted by the new leadership model proposed by the NHS.

A new integrated model is made available for a subsequent step of empirical implementation and validation through its application in a healthcare organization. The main advantage of this model is the ability to measure and manage IC and financial/non-financial performance. Moreover, the use of a single measurement system facilitates the interpretation and coherency assessment of measured data so originated.

The added value this work provides will enrich the academic literature regarding performance measurement systems in healthcare organizations, also providing an original integrated model that is able to exhibit the advantages highlighted above.

The purpose of this paper is to review the accreditation research in specific to its effect on the performance of healthcare organizations.

A comprehensive search and analysis of literature on the effect of healthcare accreditation were conducted between June 2017 and May 2018. The study identified 62 empirical research studies that examined the effect of healthcare accreditation programmes. Study particulars such as year of publication, objectives, focus of the study, research settings and key findings were recorded. A content analysis was performed to identify the frequency of the main themes in the literature. Knowledge gaps needing further examination were identified.

Majority of the accreditation impact studies were carried out in the developed nations (n = 49). The thematic categories, that is the impact on “patient safety and healthcare quality” (n = 26), “healthcare professionals’ views” (n = 28) and “clinical process and outcomes” (n = 17) were addressed more times. Whereas the other two thematic categories “organizational performance” and “consumers’ views or satisfaction,” each was examined less than 10 instances. This review reveals mixed views on effect of healthcare accreditation. The varied quality of studies and the availability of a few studies on consumers’ perception of accreditation effectiveness were the important limiting factors of this review.

The findings are valuable to healthcare managers and hospital administrators in accreditation decisions, whereas findings are of value to researchers and academicians in terms of gaps identified for future research studies pertaining to the impact of healthcare accreditation. Future studies need to consider holistic theoretical frameworks for assessing the effect of accreditation on performance of healthcare organizations to achieve precise results.

The purpose of this paper is to evaluate the effect of the Albertina Sisulu Executive Leadership Programme in Health (ASELPH) in improving the competencies and performance of public healthcare managers in South Africa (SA).

This study used a quasi-experimental study design, with pre-post assessments to assess the performance and competencies of students participating in a public health leadership programme. Students were assessed using a 360° assessment of 14 competencies and 56 performance indicators.

Students improved significantly in 11 competencies and 44 performance indicators; they perceived improvements in their own performance. The assessors observed the same improvements, which confirmed performance change at the students’ workplaces. The study showed the positive effect of the ASELPH Fellowship in improving the competencies and performance of public healthcare managers in SA.

The ASELPH Fellowship enhanced the leadership competencies and the performance of South African public healthcare managers. South African public healthcare managers face significant challenges and concerns have been raised regarding the competencies of healthcare managers to deal with these challenges. This study shows that leadership programmes can improve competencies and performance of managers to have an impact on the South African healthcare system

Improving the quality of patient care is a challenge that calls for a multidisciplinary approach, embedding a broad spectrum of knowledge and involving healthcare professionals from diverse backgrounds. The purpose of this paper is to present an innovative approach that implements discrete‐event simulation (DES) as a decision‐supporting tool in the management of Six Sigma quality improvement projects.

A roadmap is designed to assist quality practitioners and health care professionals in the design and successful implementation of simulation models within the define‐measure‐analyse‐design‐verify (DMADV) or define‐measure‐analyse‐improve‐control (DMAIC) Six Sigma procedures.

A case regarding the reorganisation of the flow of emergency patients affected by vertigo symptoms was developed in a large town hospital as a preliminary test of the roadmap. The positive feedback from professionals carrying out the project looks promising and encourages further roadmap testing in other clinical settings.

The roadmap is a structured procedure that people involved in quality improvement can implement to manage projects based on the analysis and comparison of alternative scenarios.

The role of Six Sigma philosophy in improvement of the quality of healthcare services is recognised both by researchers and by quality practitioners; discrete‐event simulation models are commonly used to improve the key performance measures of patient care delivery. The two approaches are seldom referenced and implemented together; however, they could be successfully integrated to carry out quality improvement programs. This paper proposes an innovative approach to bridge the gap and enrich the Six Sigma toolbox of quality improvement procedures with DES.

Based on the dynamic capabilities view, the current study aims to empirically investigate the effects of organizational learning culture (OLC), strategic reconfiguration (SREC) and digital transformation (DT), altogether, on Egyptian private hospitals' strategic renewal in the face of the COVID-19 pandemic.

This study adopted a cross-sectional design to collect the data used to carry out mediation analysis. A self-administered questionnaire was used to collect data from a sample consisted of 264 Egyptian private hospitals. The smart partial least square structural equation modeling technique (PLS-SEM) was adopted to test the hypotheses.

The results demonstrate that OLC directly and positively affects SR. Besides, SREC and DT partially and serially mediate the OLC-SR relationship.

The sample size was small, covering only Egyptian private hospitals. The results may be different in the manufacturing sector and in other countries. The study was cross-sectional which is limited to trace long-term effects of OLC, SREC and DT on SR. Accordingly, a longitudinal study may be undertaken.

Private hospitals' managers must actively explore and dig out valuable resources in order to discover potential information and trends endeavor to redesign internal structures, and reconfigure their current resources, structures and strategies to achieve strategic renewal. The findings also provide new insights to mangers of private sectors' institutions and direct their attention toward adopting the strategic renewal option to survive amidst crises instead of retrenchment, persevering, or quitting business.

The study's results imply that health care providers have sought to improve the capacities of their health care systems to address the patient-level social needs through continuous learning, internal reconfigurations and the transformation toward digitalization to renew their services.

This study therefore contributes to SR literature by being the first empirical study to introduce an integrative model for the antecedents of SR amidst the pandemic.

The fastest growing sector of the prison population is older people. Although the numbers are still relatively small (just under 2,500 in 2007), it would seem that the ‘sameness’ principle within prisons renders older prisoners invisible. The health of older prisoners is a matter of concern ‐ research indicates that you age 10 years faster in prison (Uzoaba, 1998) which can compound the problems that may be associated with ageing. The provision of health and social care do not match those for older people outside of the prison system. This article considers the legal issues surrounding the treatment of older prisoners. It recognises that restrictions on liberty are a component of the prison system; however, it questions whether the consequences of ‘sameness’ infringe the legal rights of older prisons. It recommends a statutory presumption of equivalence of care, which can only be rebutted expressly or by necessary implication.

The purpose of this paper is to identify how the introduction and dissemination of the 5S-KAIZEN-TQM approach positively influence the Egyptian health sector and its sustainability. It also seeks to encourage effective and efficient introduction of the 5S-KAIZEN-TQM approach into the health sectors of low- and middle-income countries.

The pilot program introducing the 5S-KAIZEN-TQM approach into five Egyptian public hospitals spanned over 13 months from January 2016 to February 2017. During the pilot program, a series of interventions occurred to introduce the approach, such as seminars on the 5S and KAIZEN approach, consultation visits and progress report meetings. Data and information were collected through conducting interviews, observing directly and evaluating the implementation progress of 5S-KAIZEN-TQM activities.

The study identified the following factors in effective and efficient dissemination of 5S-KAIZEN-TQM activities in the Egyptian health sector: restructuring the quality management structure to establish Quality Improvement Teams and Work Improvement Teams in hospitals, generating strong leadership and commitment among leaders, conducting effective in-house trainings on the 5S-KAIZEN-TQM approach, monitoring and following up on 5S-KAIZEN-TQM activities and introducing the 5S-KAIZEN-TQM approach using non-clinical sections, which could also influence the sustainability of the activities.

This study holds value in its clarification of meaningful ways to disseminate and encourage the sustainability of the 5S-KAIZEN-TQM approach in Egyptian public health facilities. Moreover, officials from the Ministry of Health and Population and hospital managers in Egypt can use the findings to plan and disseminate this approach nationwide.