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This study aimed to propose a performance-oriented approach of automatically generative design and optimization of hospital building layouts in consideration of public health emergency, which intended to conduct reasonable layout design of hospital building to meet different performance requirements for both high efficiency during normal periods and low risk in the pandemic.

The research design follows a sequential mixed methodology. First, key points and parameters of hospital building layout design (HBLD) are analyzed. Then, to meet the requirements of high efficiency and low risk, adjacent preference score and infection risk coefficient are constructed as constraints. On this basis, automatic generative design is conducted to generate building layout schemes. Finally, multi-objective deviation analysis is carried out to obtain the optimal scheme of hospital building layouts.

Automatic generative design of building layouts that integrates adjacent preferences and infection risks enables hospitals to achieve rapid transitions between normal (high efficiency) and pandemic (low risk) periods, which can effectively respond to public health emergencies. The proposed approach has been verified in an actual project, which can help systematically explore the solution for better decision-making.

The form of building layouts is limited to rectangles, and future work can explore conducting irregular layouts into optimization for the framework of generative design.

The contribution of this paper is the developed approach that can quickly and effectively generate more hospital layout alternatives satisfying high operational efficiency and low infection risk by formulating space design rules, which is of great significance in response to public health emergency.

Theory of Constraints (TOC), though a well-established process improvement methodology in manufacturing, is still a novel philosophy for healthcare and an exhaustive review of literature is needed to summarize the key findings of various researchers. Such a review can provide a direction to the researchers and academicians interested in exploring the application of TOC in the healthcare sector. This paper aims to review the existing literature of TOC tools and techniques applied to the healthcare environment, and to investigate motivating factors, benefits and key gaps for identifying directions for future research in the domain of healthcare.

In this paper, different electronic repositories were searched using multiple keywords. The current study identified 36 articles published between January 1999 to mid-2021 to conceptualize and summarize the research questions used in the study. Descriptive analysis along with pictorial representations have been used for better visualization of work.

This paper presents a thorough literature review of TOC in healthcare and identifies the evolution, current trends, tools used, nature of services chosen for application and research gaps and recommends future direction for research. A variety of motivating factors and benefits of TOC in healthcare are identified. Another key finding of this study is that almost all implementations listed in literature reported positive outcomes and substantial improvements in the performance of the healthcare unit chosen for study.

This paper provides valuable insight to researchers, practitioners and policymakers on the potential of TOC to improve quality of services, flow of patients, revenues, process efficiency and cost reduction in different health care settings. A number of findings and suggestions compiled in the paper from literature study can be used for diagnosing, learning and making substantial changes in healthcare. The methodologies used by different researchers were analysed and combined to propose a generic step by step procedure to apply TOC. This methodology will guide the practising managers about the appropriate tools of TOC for their specific need.

Good health is always the first desire of all men and women around the globe. The global aim of healthcare is to quickly cure more patients and ensure healthier population both today and in future. This article will work as a foundation for future applications of TOC in healthcare and guide upcoming applications in the booming healthcare sector. The paper will help the healthcare managers in serving a greater number of patients with limited available resources.

This paper provides original collaborative work compiled by the authors. Since no comprehensive systematic review of TOC in healthcare has been reported earlier, this study would be a valuable asset for researchers in this field. A model has been presented that links various benefits with one another and clarifies the need to focus on process improvement which naturally results in these benefits. Similarly, a model has been presented to guide the users in implementation of TOC in healthcare.

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.

Older people living in nursing homes have complex care needs and frequently need specialists’ advice and support that can be challenging to deliver in a rural setting. The aim of this paper is to describe a model of integrated care in a rural area supported by a nurse case manager.

A real-world evidence study of people living in Ribes de Freser nursing home, was conducted between specific timeframes in 2019 and 2022, comparing the casemix and outcomes of a traditional care model with the integrated interdisciplinary model.

The integrated care model led to a significant reduction in transfers to the emergency department, hospitalisations, outpatient medical visits and a reduction in the number of medicines. In addition, the number of residents receiving end-of-life care at the nursing home showed a substantial increase.

This case study contributes valuable evidence supporting the implementation of an integrated model of nurse case manager support in nursing homes, particularly in the rural contexts, where access to specialist medical staff may be limited. The findings highlight the potential benefits of person-centred integrated care for older adults, addressing their complex needs and improving end-of-life care in nursing home settings.

Violence toward frontline health-care workers (HCWs) from patients and visitors is a pervasive issue that ranges from verbal and psychological abuse to physical assault. The emergence of the COVID-19 pandemic has led to increased reports of escalated verbal workplace aggressions (VWPAs); however, most studies have been conducted internationally. Studies based in the USA have focused on physical violence experienced by nurses and paramedics in emergency situations. The purpose of this study is to learn about the experiences of different levels of frontline HCWs with VWPA from patients and visitors and discover ways to address this issue.

This qualitative descriptive study asked registered nurses, licensed practical nurses and patient care technicians from one health-care system about their experiences with patient and visitor VWPA using an anonymous, voluntary open-ended survey and in-person interviews. In all, 31 participants completed the survey and 2 were interviewed. Data were analyzed using content analysis.

Three themes emerged from the data: the experience, moving through and moving forward. Frontline HCWs described experiences of VWPA, indicating its forms, frequency and conditions. They used coping, along with personal and professional measures, to manage and move through the situation. Moving forward was captured as suggestions for the future and conveyed hope for a perfect state.

The experiences of frontline HCWs offered insight into how they perceive and cope with difficult encounters. Recommendations relate to not only implementing interventions that support frontline HCWs but also creating a culture where aggression is not tolerated and addressing perpetrator behavior is a priority.

Diffusion of innovations, defined as the adoption and implementation of new ideas, processes, products, or services in health care, is both particularly important and especially challenging. One known problem with adoption and implementation of new technologies is that, while organizations often make innovations immediately available, organizational actors are more wary about adopting new technologies because these may impact not only patients and practices but also reimbursement. As a result, innovations may remain underutilized, and organizations may miss opportunities to improve and advance. As innovation adoption is vital to achieving success and remaining competitive, it is important to measure and understand factors that impact innovation diffusion. Building on a survey of a national sample of 654 clinicians, our study measures the extent of diffusion of value-enhancing care delivery innovations (i.e., technologies that not only improve quality of care but has potential to reduce care cost by diminishing waste, Faems et al., 2010) for 13 clinical specialties and identifies healthcare-specific individual characteristics such as: professional purview, supervisory responsibility, financial incentive, and clinical tenure associated with innovation diffusion. We also examine the association of innovation diffusion with perceived value of one type of care delivery innovation – artificial intelligence (AI) – for assisting clinicians in their clinical work. Responses indicate that less than two-thirds of clinicians were knowledgeable about and aware of relevant value-enhancing care delivery innovations. Clinicians with broader professional purview, more supervisory responsibility, and stronger financial incentives had higher innovation diffusion scores, indicating greater knowledge and awareness of value-enhancing, care delivery innovations. Higher levels of knowledge of the innovations and awareness of their implementation were associated with higher perceptions of the value of AI-based technology. Our study contributes to our knowledge of diffusion of innovation in healthcare delivery and highlights potential mechanisms for speeding innovation diffusion.

Research has examined how new ventures strengthen local economic outcomes; however, limited research examines health-oriented ventures and their impact on social outcomes, including health outcomes. Increased VC investment in healthcare service start-ups signals more activity toward this end, and the need for further academic inquiry. We examine the relationship between these start-ups and county-level health outcomes, health factors, and hospital utilization.

Data on start-ups funded via institutional venture capital from PitchBook were merged with US county-level outcomes from the County Health Rankings and Area Health Resources Files for 2010 to 2019. We investigated how the number of VC-funded healthcare service start-ups, as well as a subset defined as innovative, were associated with county-level health measures. We used panel models with two-way fixed effects and Propensity Score Matched (PSM), controlling for demographics and socioeconomic factors.

Each additional VC-funded healthcare service start-up was related to a significant 0.01 percentage point decrease in diabetes prevalence (p < 0.01), a decrease of 1.54 HIV cases per 100,000 population (p < 0.1), a 0.02 percentage point decrease in obesity rates (p < 0.01), and a 0.03 percentage point decrease in binge drinking (p < 0.01). VC-funded healthcare service start-ups were not related to hospital utilization.

This work expands our understanding of how industry-specific start-ups, in this case healthcare start-ups, relate to positive social outcomes. The results underscore the importance of evidence-based evaluation, the need for expanded outcome measures for VC investment, and the possibilities for integration of healthcare services and entrepreneurship ecosystems.

Sharing patient health information (PHI) among hospitals has been much slower than the adoption of health record systems. This paper aims to investigate if privacy regulation (PR) or security measures (SMs) influence hospitals’ use of health information exchange (HIE) to share PHI with other providers (e.g. physicians, labs, hospitals). The study specifically focuses on how multiple PRs can impede and a strong national security infrastructure (NSI) can support HIE.

The study uses secondary data from a multi-national and multi-hospital survey administered by the European Union. The multi-level structure of the cross-sectional panel data is used to test the influence of both hospital-level (e.g. PR) and national-level variables (e.g. NSI) on HIE. A total of nine types of HIE, three types of PRs, nine SMs and other relevant control variables are considered. This study uses a two-level random intercept generalized linear model to test the hypothesis proposed in the study.

The study finds that national-level PRs (NLPR) have the strongest positive influence on HIE in comparison to regional (RLPR) and hospital-level (HLPR) PRs. Moreover, the study finds evidence that the presence of RLPR and HLPR, on average, decreases the positive impact of NLPR by 264%. The SMs also have a significant and positive impact on HIE. Adoption of an additional SM can increase the odds of engaging in a certain type of HIE between 21% and 61%. On the other hand, a strong NSI can also amplify the positive impact of SM on certain types of HIE.

This study extends prior research on the role of PRs in enabling HIE by considering the complexities brought up by adopting multiple PRs. NLPRs have the strongest impact on HIE in comparison to RLPRs or HLPRs. Moreover, public infrastructure initiatives such as those related to secure communications can also complement SMs adopted by the providers by encouraging HIE.

While the main emotional labor strategies are well-documented, the manner in which professionals navigate emotional rules within the workplace and effectively perform emotional labor is less understood. With this contribution, I aim to unveil “the good, the bad and the ugly” of emotional labor as a dynamic theatrical performance.

Focusing on three geriatric long-term care units within a French public hospital, this qualitative study relies on two sets of data (observation and interviews). Deeply rooted within the field of study, the chosen methodological approach substantializes the subtle hues of the emotional experience at work and targets resonance rather than generalization.

Using the theatrical metaphor, this research underlines the role of space in the practice of emotional labor in a unique way. It identifies the main emotionalized zones or emotional regions (front, back, transitional, mixed) and details their characteristics, before unearthing the nonlinearity and polyphonic quality of emotional labor performance and the versatility needed to that effect. Indeed, this research shows how health-care professionals juggle with the specificities of each region, as well as how space generates both constraints and resources. By combining static and dynamic prisms, diverse instantiations of hybridity and spatial in-betweens, anchored in liminality and trajectories, are revealed.

This research adds to the current body of literature on the concept of emotional labor by shedding light on its highly dynamic and interactional nature, revealing different levels of porosity between emotional regions and how the characteristics of each type of area can taint others and increase/decrease the occupational health costs of emotional labor. The study also raises questions about the interplay of emotional labor performance with the level of humanization/dehumanization of elderly people. Given the global demographics about an aging population, this gives food for thought at a social level.

This study examines the theoretical and empirical relationships between LM&SS, human resource management (HRM), climate for LM&SS and outcomes (employee well-being and performance) in hospitals. As part of this research, the authors examine the interplay between “hard” and “soft” practices for LM&SS and “soft” HR practices.

A cross-sectional, multisite survey study covering all internal service units at all eight Dutch university hospitals was conducted (42 units, N = 218 supervisors, N = 1,668 employees), and multivariate multilevel regression analyses were performed.

A systems approach involving “soft” LM&SS practices that are specifically HR-related has a positive effect (β is 0.46) on a climate for LM&SS. A climate for LM&SS is not related to perceived performance or employee health. It is, however, positively related to employee happiness and trusting relationships (both βs are 0.33). We did not find that a climate for LM&SS had a mediating effect.

This study shows that a balanced approach involving both “hard” and “soft” factors is crucial to achieving the desired breadth and depth of LM&SS adoption at the macro, meso, and micro levels. The authors found that a climate for LM&SS positively affects employee well-being in hospitals.

In their attempt to create mutual gains for both their organization and their employees, hospitals that adopt LM&SS should foster a climate for LM&SS by embracing a balanced approach consisting of both “hard” and “soft” practices, thereby internalizing LM&SS at the macro, meso, and micro levels.

This is one of the first studies to examine in-depth the impact of “hard” and “soft” LM&SS on both employee well-being (subdivided into different components) and performance in healthcare, as well as the role of “soft” HRM in this relationship. Linking LM&SS, HRM and outcomes to a climate for LM&SS is relatively a new approach and has led to a deeper understanding of the mechanisms underpinning the internalization of LM&SS in healthcare.