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Overcrowding continues to afflict emergency departments (EDs), and its attendant consequences are becoming increasingly severe. The burden of the COVID-19 pandemic is further escalating the situation worldwide. One of the most critical questions is how to adequately quantify what constitutes overcrowding and determine implications for operations management in improving service efficiency. This paper aims to discuss the aforementioned.

The authors propose the time and class complexity measures for ED service systems, taking into account important patient-level and system characteristics. Using an extensive data set from a Canadian ED, the authors investigate the performance of complexity-based measures in predicting service delays.

The authors find that the complexity measure is potentially more important than some well-known crowding metrics. In particular, EDs can improve service efficiency by managing the level of complexity within a desirable interval. Furthermore, complexity exposes how the interplay between demand-side behavioral changes and supply-side responses affects operational performance. Moreover, the results suggest that arrival patterns—the number of patients of each class arriving per time and times between events (arrivals and service completions)—increase the risk of service delays more than the demand volume.

This paper is the first to provide an extensive investigation into the application of the complexity-based measure for ED crowding. The study demonstrates potential values to be gained in ED service systems if complexity measure is incorporated into their operations management decisions.

This study aims to explore the good crowding effect among Indian domestic travellers during the COVID-19 pandemic in the context of the city destination. This study uses the framework of social motivation theory to achieve the objective.

This study adopted a qualitative research design by taking the case of Shimla, Himachal Pradesh. Using purposive sampling, semi-structured interviews were conducted with 37 respondents, and themes were drawn manually.

The analysis found four themes that create a good crowding effect among domestic tourists, namely, convenience and price; familiarity and place attachment; social affiliation; and safety. The themes indicated that despite the pandemic, and constant occurrences of new variants, Indian domestic tourists’ on-site attitude towards crowding was favourable.

Firstly, the good crowding effect during the pandemic could have been better understood using empirical data. Secondly, the results cannot be generalized, specifically for developed economies.

This study offers practical implications to destination managers and local administrative bodies for whom achieving sustainability in urban tourism has always been concerning. These include developing infrastructural facilities, encouraging cultural activities in city centres and improving the perception of safety to sustain the good crowding effect.

The affective dimension involved in making a travelling decision played a significant role in the post-pandemic phase. While suppliers needed survival, tourists needed social affiliation and escape from the mandated home isolation due to multiple phases of COVID-19 lockdown in India. This study adds value to society by emphasising that the need for social affiliation among travellers remains intact, and the tourism industry should embrace this transformation.

While most of the pandemic-related studies criticised crowd and tourists’ crowd averting behaviour, this study reported that the good crowding effect could also be an outcome owing to different factors. Therefore, this study offers distinctive nuance of tourists’ behaviour in the post-COVID-19 phase, allowing destination managers and tourism stakeholders to re-think their strategies.

The most common reaction to an acute physical illness is anxiety, which may be followed by depression. In patients with chronic diseases, the prevalence of anxiety disorders and depression is almost twice as high as in other diseases. This study aims to extract prominent components in the design of treatment spaces on reducing hospitalized patients’ depression from both experts and patients/users’ point of views. A final model is also presented based on the findings.

This research used an exploratory mixed method. The effective components were extracted through the administration of two Likert-scale researcher-made questionnaires in two phases. Q factor analysis was conducted to reach the components. A total of 205 patients were admitted to Namazi Hospital in Shiraz, and 20 architecture and psychology experts participated in the survey. Final modeling of the data was done through path analysis.

Six factors were found to be effective by experts in reducing depression in therapeutic spaces: nature-oriented space, targeted social space, diverse space, visual comfort, logical process and safe space. On the part of patients, seven components were deemed to be effective: visual perception, naturalism, functionalism, physical security, logical process, psychological safety and diversity. Also, four main cycles were extracted from the final model with the direct effect of diversity and the other five cycles were mediated by naturalism.

A total of 15 interviews with architects and psychologists, who were available at the time of the study, were conducted in January 2018. The only general question during interviews was “In your opinion, what factors are effective in reducing the level of depression of patients in the design of treatment spaces?” This may have limited the range of factors that could be surveyed in the study. After collecting the effective factors from the aforementioned expert’s points of view, the questionnaire of experts was designed (Appendix). The expert questionnaires were distributed and edited in two stages in January 2019 among 20 architect experts who were available at the time of the study. The one-year interval between designing and administering the questionnaires occurred because of the limitations posed by the COVID-19 pandemic situation. However, the interval did not pose methodological obstacles for the study.

Evidence-based investigation of the effectiveness of proper design components of therapeutic spaces in reducing the symptoms of patients with chronic secondary depression has received little attention in the literature. Using a “conceptual model,” the present study brought the issue into its focus so as to find effective components in the design of treatment spaces that can alleviate depression symptoms in chronically hospitalized patients.

Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a shift from acute, episodic and reactive hospital-centered care toward longitudinal, person-centered and proactive home-centered care. The purpose of this paper is to contribute to the knowledge of a comprehensive development strategy for designing and providing home-centered care of older people.

The study design is based on qualitative research with an inductive approach. The authors study development initiatives at the national, regional and local levels of the Swedish health and social care system. The data collection methods included interviews (n = 54), meeting observations (n = 25) and document studies (n = 59).

The authors describe findings related to policy actions and system changes, attempts to achieve collaboration, integration and coordination, new forms of care offerings, characteristics of work settings at home and differences in patients' roles and participation at home and in the hospital.

The authors suggest home-centered care as a solution for providing person-centered and integrated care of older people and give examples of how this can be achieved.

The authors outline five propositions for research and development related to national policies, service modularity as a solution for customized and coordinated care, developing human resources and infrastructure for home settings, expanding services that enable older people living at home and patient co-creation.

This study aims to investigate the physical environmental problems of two Thai community hospitals’ outpatient departments (OPDs) during the COVID-19 outbreak and to provide design guidelines for respiratory disease prevention.

A three-step method was used. The first step involved walk-through observations at Mae Wang Hospital and Doi Saket Hospital to assess the physical environment. The second step consisted of interviews with 22 medical staff working in the two hospitals. Third, the observation and interview data were used to develop a preliminary design guideline, which was evaluated by two focus groups comprising the same interview participants.

The observational findings showed that the two hospitals had difficulties following the COVID-19 prevention protocol due to physical environmental problems. Four different themes emerged from the analysis of the medical staff interviews. The preliminary design guidelines that were evaluated through two focus group discussions resulted in design recommendations for four areas (the overall building, clinical, support and staff areas) in the Mae Wang and Doi Saket OPD buildings. Three topics of design recommendations were provided to reduce the spread of COVID-19: improving hospital management, space design and air quality.

To the best of the authors’ knowledge, this study is the first to provide design guidelines for COVID-19 and respiratory disease prevention in Thai community hospital OPD buildings.

The Astroworld concert tragedy is used as an example of crisis (mis)management and the potential utility of the 4R model. Although the 4R model has been implemented in high-risk emergency management situations, it is useful in the PR field because of its actionable approach, creating a way for practitioners to prepare for and manage crisis situations.

This is an analysis of the crisis that occurred at Astroworld, spanning preparation, day-of events, casualties and enduring reputational impact. The paper applies the 4R method to the Astroworld tragedy to show how it could have lessened or even prevented the tragedy. Finally, the SCCT model is used to explain why the official post-crisis statements were ineffective.

Social media has heightened the importance of a quick and effective organizational response to risk and crisis situations because poor responses can go viral quickly. However, social media also provides intelligence and crowd sourced information that can inform PR practitioners of emerging crisis scenarios. It is also an underutilized tool for two-way communication during crises.

The 4R approach is beneficial to general practitioners as it simplifies crisis best-practices, something essential for quick action. As our world changes and becomes less predictable, practitioners must have a clear plan to protect their organizations and the public surrounding them. This approach includes reduction, readiness, response and recovery, which are all essential in crisis communication.

The 4R method has not been explored or applied in the PR field. This paper highlights how the model has been utilized in the emergency management field and illustrates the way 4R can serve the PR field.

The study investigates the relationship between hospital environmental factors and the well-being of geriatric in-patients. It aims to identify the impact of architectural design on comfort, safety, privacy and stress levels experienced by elderly patients during their hospital stays.

Employing a mixed-methods approach, the research assesses the experiences of 100 geriatric in-patients across various hospital types through surveys, observational checklists and state anxiety measurements. The methodology involves examining architectural features, patient perceptions and correlations among environmental variables and patient experiences. Statistical analyses, including correlations and chi-square tests, were employed to discern associations between environmental variables and patient experiences.

The research identified key architectural features significantly impacting geriatric patients' experiences. Factors such as sturdy beds, furniture quantity, lighting conditions, proximity to facilities and ward occupancy levels were found to influence spatial, sensory and social comfort. Notably, proximity to facilities and control over the immediate environment were crucial for self-control and safety perceptions. Privacy, highly valued by patients, correlated with the presence of curtains and ward occupancy. Moreover, patient stress levels exhibited correlations with autonomy, privacy and ward occupancy.

This research offers significant insights into the criticality of specific architectural elements in enhancing comfort and reducing stress for geriatric in-patients. These findings hold substantial value for healthcare facility design, emphasizing the need to prioritize certain design aspects to promote the well-being of elderly patients during hospitalization.

This study aims to explore the empirical correlation between patient flow issues, quality of green health services and patient satisfaction in specialist medical department factors from patients’ perspectives as service consumers.

This research is a type of nonintervention empirical research that uses an open survey to explore the views and experiences of users of specialist medical department services. The targeted population is hospital patients included in the top five national PERSI (Indonesian Hospital Association) Award 2022 Green Hospital Category, with a total number of respondents of 572 people. This study uses the partial least square-structural equation modeling analysis method with the SmartPLS application.

Patient flow problems generally affect the quality of eco-friendly health services, except for the waiting time problem, which affects service quality. It should be understood as a top priority for patients to receive services from medical specialists without risking time as a core service aspect from the patient’s perspective. In addition, all variables in eco-friendly hospital services affect patient satisfaction, except in the case of visits to specialist medical departments, which do not affect medical support services and hospital practices that are responsive to the delivery of care services resulting from medical support services that are inseparable in integrated services as well as health care following medical ethics.

This study has a novelty in understanding the implications of green practice in determining patient satisfaction in medical specialist department as the epicenter of hospital services and the main object of assessment for the quality of hospital services.

This study aims to identify the impact of restaurant pandemic mitigation measures on perceived service quality.

A total of 15,251 reviews were collected from 300 TripAdvisor Lisbon restaurant Web pages between March 2020 and December 2021, when Covid-19 contingency measures were in place. Grounded on the online reviews, a word frequency matrix was created and used as input on partial least squares–structural equation modeling to test the proposed hypotheses.

The results suggest that precaution measures, such as the Vaccination Certificate, negative tests and restaurant layout configuration, positively influenced perceived service quality and consumer satisfaction, moderated by consumers’ beliefs.

This study provides relevant information for restaurant managers, which will help them implement strategies to guarantee service quality, consumer satisfaction and revisit intentions in future pandemic scenarios.

This study investigates the observed resurgence in religious beliefs seen across many societies during the COVID-19 pandemic. Using the economic theory of religious clubs, the author models religious participation during the pandemic as a mechanism for alleviating the financial distress associated with the health distress from the pandemic.

Using data from the COVID-19 National Longitudinal Phone Survey (NLPS) in Nigeria, the author investigates the economic motivation for religious intensity during the COVID-19 pandemic. To address endogeneity concerns, the author exploits geographic variables of temperature and longitudes as sources of COVID-19 risk.

Overall, health distress stimulates religious intensity. Consistent with the economic theory of religious clubs, adverse health shocks stimulate financial distress, and the effect is stronger among religious participants. Similarly, people see God and not the government as a source of protection against COVID-19.

The study’s model sees religious organizations as public goods providers, especially when governments and markets are inefficient.

The study’s recommendations support an expanded role for religious networks in healthcare delivery and more public funding to attenuate the post-pandemic resurgence of social violence in economically distressed regions.

Despite the research interest in the COVID-19 pandemic, the long-term implications, many of which relate to social behavior adjustments that cause individuals to identify more closely with their social group, need greater understanding. Suppose religious intensity is linked to economic distress. In that case, this is a major source of worry for countries whose economies are subject to higher fluctuations and where the governments and markets are inefficiently organized. These regions may be more susceptible to a resurgence in religious fundamentalism associated with the economic shocks from the pandemic. Consequently, these regions would require more public funding to attenuate the potential for costly activities like organized violence, suicide attacks and terrorist activities in the aftermath of the pandemic.

Prompted by the observation of the increase in religious identity through religious intensity during the pandemic, the author contributes by developing theoretically-based hypotheses that are incentive-compatible to provide a rational justification for the observation. The author empirically validates the hypothesis by taking advantage of the COVID-19 National Survey in Nigeria by specifically using survey rounds 4 and 7 which have more comprehensive religious items included.

The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-11-2022-0719