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This integrated care study seeks to highlight how voluntary sector “wellbeing co-ordinators” co-located in a horizontally and vertically integrated, multidisciplinary community hub within one locality of an Integrated Care Organisation contribute to complex, person-centred, co-ordinated care.

This is a naturalistic, mixed method and mixed data study. It is complementing a before-and-after study with a sub-group analysis of people receiving input from the wider hub (including Wellbeing Co-ordination and Enhanced Intermediate Care), qualitative case studies, interviews, and observations co-produced with embedded researchers-in-residence.

The cross-case analysis uses trajectories and outcome patterns across six client groups to illustrate the bio-psycho-social complexity of each group across the life course, corresponding with the range of inputs offered by the hub.

To consider the effectiveness and mechanisms of complex system-wide interventions operating at horizontal and vertical interfaces and researching this applying co-produced, embedded, naturalistic and mixed methods approaches.

How a bio-psycho-social approach by a wellbeing co-ordinator can contribute to improved person reported outcomes from a range of preventive, rehabilitation, palliative care and bereavement services in the community.

To combine knowledge about individuals held in the community to align the respective inputs, and expectations about outcomes while considering networked pathways based on functional status, above diagnostic pathways, and along a life-continuum.

The hub as a whole seems to (1) Enhance engagement through relationship, trust and activation, (2) Exchanging knowledge to co-create a shared bio-psycho-social understanding of each individual’s situation and goals, (3) Personalising care planning by utilising the range of available resources to ensure needs are met, and (4) Enhancing co-ordination and ongoing care through multi-disciplinary working between practitioners, across teams and sectors.

For over 40 years, Canadian and international bodies have endorsed comprehensive primary health care (PHC), yet very little work has been done to describe how services and programs are delivered within these organizations. Because health equity is now of greater interest to policy makers and the public, it is important to describe an evidence-informed framework for the delivery of integrated and equitable PHC. The purpose of this paper is to describe the development of a “Model of Health and Well-being” (MHWB) that provides a roadmap to the delivery of PHC in a successful network of community-governed PHC organizations in Ontario, Canada.

The MHWB was developed through an iterative process that involved members of community-governed PHC organizations in Ontario and key stakeholders. This included literature review and consultation to ensure that the model was evidence informed and reflected actual practice.

The MHWB has three guiding principles: highest quality health and well-being for people and communities; health equity and social justice; and community vitality and belonging. In addition, there are eight attributes that describe how services are provided. There is a reasonable evidence base underpinning the all principles and attributes.

As comprehensive, equitable PHC organizations become increasingly recognized as critical parts of the health care system, it is important to have a means to describe their approach to care and the values that drive their care. The MHWB provides a blueprint for comprehensive PHC as delivered by over 100 Community Governed Primary Health Care (CGPHC) organizations in Ontario. All CGPHC organizations have endorsed, adopted and operationalized this model as a guide for optimum care delivery.

The purpose of this paper is to contribute theoretical ideas of how peer support workers (PSWs) bring added value to interprofessional learning (IPL) in mental health care teamwork. The question is: How can we theoretically understand the value of PSWs’ expertise for IPL in mental health care teamwork?

Initially, the authors formulate a hypothesis. Then, the authors describe the focus and context in IPL and PSWs, respectively, and the PSWs’ and mental health professions’ different roles, expertise and perspectives. The authors also refer to some peer provided programs related to IPL. Finally, the authors construct an outline and apply ideas from Wenger’s Communities of Practice (CoP).

Using CoP, the PSWs as newcomers can by their perspectives change mental health professions’ perspectives and stimulate IPL in teamwork.

The paper gives theoretical insights of how PSWs can facilitate IPL in mental health care teamwork.

Recent literature within public service logic has called for more explicit conceptualisation of customer value in public services. This study aims to fill this gap by examining how the customer value approach can be applied in the management of public health care services.

This study is a qualitative case study of management of public health care services in Finland. The authors interviewed 17 regional health care service developers and analyzed the interview data using thematic analysis.

The study suggests five propositions for applying customer value approach from the marketing literature in public health care service management. The study enables a deeper understanding of customer value creation in this context and improvement of public health care services.

This study contributes to the public management research in general and public service logic research in particular by suggesting what constitutes customer value in public health care services.

The purpose of this study is to develop a model describing different factors that affect quality and efficiency in transitional care.

A meta-synthesis focusing on the transitions between wards was conducted within a research project. The results from eight studies within that research project have been combined and analysed from a holistic view.

The findings are a model with a description of seven different categories consisting of the identified factors affecting quality and efficiency in transitional care. Those categories are (1) learning organisation, (2) standardising and structuring, (3) applying a holistic view, (4) understanding organisational culture in a health care context, (5) management and leadership, (6) for whom value is created and (7) working together. The results from the study have been verified in previous research.

The result of the completed meta-synthesis is based on studies conducted at two medium-sized hospitals in Sweden. The developed model can be used in a similar context to improve quality and efficiency in patient transfers by management and employees working based on the various factors.

This model describes factors (success factors, prerequisites, conditions and lack thereof) affecting the ability to achieve quality and efficiency in transitional care that can be used in future research as well as for practical improvements.

Using financial incentives has been criticised for putting too much focus on things that can be measured. Value-based reimbursement may better align professional values with financial incentives. However, professional values may differ between actor groups. In this article, the authors identify institutional logics within healthcare-providing organisations. Further, the authors analyse how the centrality and compatibility of the identified logics affect the institutionalisation of external demands.

41 semi-structured interviews were conducted with representatives from healthcare providers within spine surgery in Sweden, where a value-based reimbursement programme was introduced. Data were analysed using thematic content analysis with an abductive approach, and a conceptual framework based on neo-institutional theory.

After the introduction of the value-based reimbursement programme, the centrality and compatibility of the institutional logics within healthcare-providing organisations changed. The logic of spine surgeons was dominating whereas physiotherapists struggled to motivate a higher cost for high quality physiotherapy. The institutional logic of nurses was aligned with spine surgeons, however as a peripheral logic facilitating spine surgery. To attain holistic and interdisciplinary healthcare, dominating institutional logics within healthcare-providing organisations need to allow peripheral institutional logics to attain a higher centrality for higher compatibility. Thus, allowing other occupations to take responsibility for quality and attain the feeling of professional pride.

Interviewing spine surgeons, physiotherapists, nurses, managers and administrators allows us to deepen the understanding of micro-level behaviour as a reaction (or lack thereof) to macro-level decisions.

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 purpose of this paper is to conceptually examine the phenomenon of wellness tourism under a holistic and systemic lens, focusing on the offer system and the main components necessary for the staging of wellness experiences. This approach to holistic wellbeing within the tourism sector has led to a broadening of the type of services and experiences that make up the value propositions that can positively contribute to people’s wellbeing.

This study identifies and defines the components of wellness tourism (including sectors not traditionally associated with it) through a review and analysis of the extant literature on “wellness tourism” and “wellbeing tourism” of the past two decades; the components were classified through an open coding process.

Wellness tourism, as a broad multidimensional concept, is composed by ten different components of the offer system: hot springs, spas, medical tourism, care of the body and mind, enogastronomy, sports, nature and environment, culture, spirituality and events. Each of these categories may represent a single touristic offer targeted to specific market segments, but they may also be one of several components within an integrated mix of tourism products proposed.

A holistic view of wellness tourism has implications for strategic marketing processes. Destination Management Organizations and company managers should segment their demand according to more innovative criteria than what has traditionally been adopted for wellness in terms of health care and medical procedures. Value propositions for tourists should be wellness-driven to satisfy the growing demand for wellness/well-being and should involve the participation of all the various actors and producers within the wellness tourism offer system at wellness destinations.

康养旅游及其组成元素：一个全方位的视角

此一论文会以全面和有系统的目光, 谈及康养旅游的现象, 并集中于康养旅游的供应系统和主要组成元素。此一以全面身心健康为目的的旅游行业, 使不同服务的覆盖范围和经验得以扩而充之, 提供有利条件正面地影响着人们的身心健康。

本研究会分辨和定义康养旅游的组成元素（以及其他在传统定义上被排除的行业）, 透过重新审视和分析近20年有关于康养旅游（Wellness tourism）和健康旅游（Wellbeing tourism）的现存文献。同时, 所有元素会以开放式译码 （open coding）来分类。

康养旅游, 作为一个多元概念, 基本上与十个不同的供应行业相关：温泉, 水療, 医疗旅游, 身心护理, 饮食, 运动, 自然环境, 文化, 灵修和特办活动。不同类别的行业可以在代表市场上不同供需关系的同时, 也可以代表供应上可以有一种混合套餐供应。

以全面的目光去看康养旅游可以为市场策略定下基础。目的地管理公司（DMO）和不同的公司经理应该在分辨服务需求的时候, 多采用新颖的标准, 摒弃只包括医疗的传统健康观念。为游客订立的价值主张（Value propositions）应以全面身心健康为主导, 以满足对康养（Wellness）和健康（Wellbeing）不断上升的需求; 亦应大力度地提升所有安康旅游工作人员与顾客的互动和参与。

El turismo de bienestar y los componentes de su sistema de oferta: una perspectiva holística

Este artículo examina conceptualmente el fenómeno del turismo de bienestar desde una perspectiva holística y sistémica, centrándose en el sistema de oferta y los principales componentes necesarios para la puesta en escena de experiencias de bienestar. Este enfoque de bienestar integral dentro del sector turístico ha propiciado una ampliación del tipo de servicios y experiencias que integran las propuestas de valor que pueden contribuir positivamente al bienestar de las personas.

Este estudio identifica y define los componentes del turismo de bienestar (incluidos los sectores no asociados tradicionalmente con él), a través de una revisión y análisis de la literatura existente sobre “turismo de bienestar” de las dos últimas décadas; los componentes se han clasificado mediante un proceso de codificación abierto.

El turismo de bienestar está compuesto conceptualmente por diez componentes diferentes de ofertas: aguas termales, spas, turismo sanitario, cuidado de cuerpo y mente, enogastronomía, deportes, naturaleza y medio ambiente, cultura, espiritualidad y eventos. Cada una de estas categorías puede representar una única oferta turística para segmentos de mercado específicos, pero también pueden ser uno de los varios componentes de una combinación integrada de productos turísticos.

Esta concepción holística del bienestar sugiere que, en el contexto de los procesos de marketing estratégico, las DMO y los gerentes de negocio deben segmentar la demanda con criterios innovadores respecto a los tradicionales de salud y médicos. Además, deben formular propuestas de turismo orientado al bienestar, valorizando los componentes de la oferta capaces de interceptar la creciente demanda de bienestar e implicando a los distintos productores del sistema de oferta de wellness que operan en los destinos de bienestar

The purpose of this study is to examine the effectiveness of the Thai nursing student competency enhancement program applied through project-based learning (PjBL) in caring for the elderly in the community.

This quasi-experimental one-group pre-post-test design was used to compare mean scores on gerontological nursing competency scales comprising four dimensions including holistic health promotion, empirical evidence, empowerment and quality care and ethical and moral competencies. A total of 95 participants were randomly selected from a list of registered attendees. A five-week PjBL approach for a community nursing practicum was designed and comprised of an introduction to the project, components of research methodology, group projects and group presentations. A gerontological nursing competencies questionnaire was used with participants, and data were analyzed using descriptive statistics. Two-way ANOVA and a paired t-test were used to compare pre-post mean scores of competencies.

A total of 95 students participated in the PjBL and the majority of participants were female (92.6%). The results revealed post–PjBL mean scores of gerontological nursing competencies were higher than the premean score (p value < 0.05) except the empirical evidence competencies which showed no statistical difference.

Since the results show the effectiveness of the student nursing competency enhancement program through PjBL when caring for the elderly in the community, it is important for health care instructors to apply PjBL, especially in community nursing. Improving empirical competency evidence among nursing students is still required and necessary.