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Nurses are one the essential health-care providers within society, seeking the employment of authentic leadership approaches to reduce the burnout and stressors established within the emergency departments. Burnout has been vitally documented as a psychological impulse that emerges due to the prevalence of chronic job stressors. Authentic leadership approaches will act as an affirmative organizational resource that could help to minimize burnout in the work environments. Therefore, this study aims to evaluate the role of authentic leadership in stress and burnout among nurses in emergency departments.

This study used a quantitative, cross-sectional design. A package of surveys was distributed to nurses working in emergency departments using standardized questionnaires that measured the study variables. A total of 188 nurses participated in the study. SPSS was used to analyze data.

The study’s results supported the hypotheses and found that authentic leadership significantly and negatively influenced nurses’ job stress R = –0.169, p = 0.0205. Also, the results of this study found that the relationship between authentic leadership and burnout was significant and negative R = –0.245, F (1,186) = 11.8, p = 0.0007.

Nurse leaders can introduce flexible working hours and develop coordination and cooperation among nurses, and management of the hospitals needs to focus on improving the structure and enhancing nurses’ outcomes that could affect patients’ and organizations’ outcomes.

The purpose of this paper is to offer an opinion piece that documents the experience of losing an adult sibling to suicide and explores the experience of personal and family grief.

This narrative is written from an autoethnographic perspective and uses the current evidence base to support a personal reflection.

This paper identifies the complex nature of bereavement following death from suicide and considers those factors that support more positive outcomes for those grieving.

This piece focuses on autoethnographic data but is supported by findings from the wider evidence base.

The importance of seeking positives as part of the healing process when processing complex grief.

Disclosure has been identified as an important part of processing complex grief associated with suicide bereavement and yet suicide remains a taboo subject for many.

This autoethnographic piece details the experience of dealing with a sibling suicide and the importance of creating the opportunity for positive reflection to process complex grief.

Reducing aircraft fuel consumption has become a paramount research area, focusing on optimizing operational parameters like speed and altitude during the cruise phase. However, the existing methods for fuel reduction often rely on complex experimental calculations and data extraction from embedded systems, making practical implementation challenging. To address this, this study aims to devise a simple and accessible approach using available information.

In this paper, a novel analytic method to estimate and optimize fuel consumption for aircraft equipped with jet engines is proposed, with a particular emphasis on speed and altitude parameters. The dynamic variations in weight caused by fuel consumption during flight are also accounted for. The derived fuel consumption equation was rigorously validated by applying it to the Boeing 737–700 and comparing the results against the fuel consumption reference tables provided in the Boeing manual. Remarkably, the equation yielded closely aligned outcomes across various altitudes studied. In the second part of this paper, a pioneering approach is introduced by leveraging the particle swarm optimization algorithm (PSO). This novel application of PSO allows us to explore the equation’s potential in finding the optimal altitude and speed for an actual flight from Algiers to Brussels.

The results demonstrate that using the main findings of this study, including the innovative equation and the application of PSO, significantly simplifies and expedites the process of determining the ideal parameters, showcasing the practical applicability of the approach.

The suggested methodology stands out for its simplicity and practicality, particularly when compared to alternative approaches, owing to the ready availability of data for utilization. Nevertheless, its applicability is limited in scenarios where zero wind effects are a prevailing factor.

The research opens up new possibilities for fuel-efficient aviation, with a particular focus on the development of a unique fuel consumption equation and the pioneering use of the PSO algorithm for optimizing flight parameters. This study’s accessible approach can pave the way for more environmentally conscious and economical flight operations.

The purpose of this paper is to report on the implementation of the World Health Organization (WHO) trauma care checklist (TCC) (WHO, 2016) in an emergency department in a tertiary hospital in Nepal. This research was undertaken as part of a Hybrid International Emergency Medicine Fellowship programme (Subedi et al., 2020) across UK and Nepal, incorporating a two-year rotation through the UK National Health Service, via the Medical Training Initiative (MTI) (AoMRC, 2017). The WHO TCC can improve outcomes for trauma patients (Lashoher et al., 2016); however, significant barriers affect its implementation worldwide (Nolan et al., 2014; Wild et al., 2020). This article reports on the implementation, barriers and recommendations of WHO TCC implementation in the context of Nepal and argues for Transformational Leadership (TL) to support its implementation.

Explanatory mixed methods research (Creswell, 2014), comprising quasi-experimental research and a qualitative online survey, were selected methods for this research. A training module was designed and implemented for 10 doctors and 15 nurses from a total of 76 (33%) of clinicians to aid in the introduction of the WHO TCC in an emergency department in a hospital in Nepal. The quasi-experimental research involved a pre- and post-training survey aimed to assess participant’s knowledge of the WHO TCC before and after training and before the implementation of the WHO TCC in the emergency department. Post-training, 219 patients were reviewed after four weeks to identify if process measures had improved the quality of care to trauma patients. Subsequently six months later, a qualitative online survey was sent to all clinical staff in the department to identify barriers to implementation, with a response rate of 26 (n = 26) (34%) (20 doctors and 6 nurses). Descriptive statistics were used to evaluate quantitative data and the qualitative data were analysed using the five stepped approach of thematic analysis (Braun and Clarke, 2006).

The evaluation of the implementation of the WHO TCC showed an improvement in care for trauma patients in an emergency setting in a tertiary hospital in Nepal. There were improvements in the documentation in trauma management, showing the training had a direct impact on the quality of care of trauma patients. Notably, there was an improvement in cervical spine examination from 56.1% before training to 78.1%; chest examination 125 (57.07%) before training and 170 (77.62%) post-training; abdominal examination 121 (55.25%) before training and 169 (77.16%) post-training; gross motor examination 13 (5.93%) before training and 131 (59.82%) post-training; sensory examination 4 (1.82%) before training and 115 (52.51%) post-training; distal pulse examination 6 (2.73%) before training and 122 (55.7%) post-training. However, while the quality of documentation for trauma patients improved from the baseline of 56%, it only reached 78% when the percentage improvement target agreed for this research project was 90%. The 10 (n = 10) doctors and 15 (n = 15) nurses in the Emergency Department (ED) all improved their baseline knowledge from 72.2% to 87% (p = 0.00006), by 14.8% and 67% to 85%) (p = 0.006), respectively. Nurses started with lower scores (mean 67) in the baseline when compared to doctors, but they made significant gains in their learning post-training. The qualitative data reported barriers, such as the busyness of the department, with residents and medical officers, suggesting a shortened version of the checklist to support greater protocol compliance. Embedding this research within TL provided a steer for successful innovation and change, identifying action for sustaining change over time.

The study is a single-centre study that involved trauma patients in an emergency department in one hospital in Nepal. There is a lack of internationally recognised trauma training in Nepal and very few specialist trauma centres; hence, it was challenging to teach trauma to clinicians in a single 1-h session. High levels of transformation of health services are required in Nepal, but the sample for this research was small to test out and pilot the protocol to gain wider stakeholder buy in. The rapid turnover of doctors and nurses in the emergency department, creates an additional challenge but encouraging a multi-disciplinary approach through TL creates a greater chance of sustainability of the WHO TCC.

International protocols are required in Nepal to support the transformation of health care. This explanatory mixed methods research, which is part of an International Fellowship programme, provides evidence of direct improvements in the quality of patient care and demonstrates how TL can drive improvement in a low- to medium-income country.

The Nepal/UK Hybrid International Emergency Medicine Fellowships have an opportunity to implement changes to the health system in Nepal through research, by bringing international level standards and protocols to the hospital to improve the quality of care provided to patients.

To the best of the authors’ knowledge, this research paper is one of the first studies of its kind to demonstrate direct patient level improvements as an outcome of the two-year MTI scheme.

This study aims to determine the influence of the role of hospital leaders, the COVID-19 budget and health service facilities at regional general hospitals (RSUDs) to Indonesia on hospital responses in overcoming the COVID-19 pandemic, moderated by hospital class level.

This research was designed as quantitative research using partial least square-structural equation modeling (PLS-SEM) to test hypotheses.

Using a sample of 185 RSUDs, it was found that the role of hospital leaders, the COVID-19 budget and health service facilities in RSUDs had a positive and significant effect on the hospital's response to the COVID-19 pandemic. The findings show that the role of hospital leaders, in this case, the RSUD director, is essential in improving health services during the COVID-19 pandemic. The COVID-19 budget and health service facilities at RSUD can run effectively during the COVID-19 pandemic if the RSUD director issues appropriate policies during the COVID-19 pandemic crisis.

This study is the first to determine the influence of hospital leaders, the health budget for COVID-19 and hospital health service facilities simultaneously on the hospital's response to the COVID-19 pandemic. This study also provides empirical evidence regarding the idea of stewardship theory, which suggests the role of leaders in supervising organizations to achieve organizational goals effectively in times of crisis.

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.

Cancer has become a priority among today’s health problems. Therefore, providing facilities that ensure high-quality cancer treatment has become an essential design problem. Additionally, a considerable number of studies have introduced the ‘healing environment concept’ as a substantial input for healthcare buildings. The purpose of this paper is to present a design guide for cancer treatment services that is compatible with the healing environment concept.

In this context, studies on the healing environment have been analyzed, and the legislation of some selected countries has been assessed. Then, all the filtered data are used to form the design guideline for chemotherapy department, radiation oncology department and inpatient care services under a new series of analysis criteria.

The resulting principles are revealed according to the criteria of general settlement principles, internal function relations, medical necessities, user experience, interior design, social interaction/privacy, safety, landscape design and outdoor relations by the help of proposed plans, diagrams and schematic drawings.

This research constitutes the first and yet only study in its field that aims to increase efficiency and user satisfaction and provide better patient-centered care while providing a design guide on health-care architecture.

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.

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.

The issue of energy efficiency is becoming increasingly prevalent globally due to factors such as the expansion of the population, economic growth and excessive consumption that is not sustainable in the long run. Additionally, healthcare facilities and hospitals are facing challenges as their operational costs continue to rise. The research aim is to develop strategic frameworks for managing green hospitals, towards energy efficiency and corporate governance in hospitals and healthcare facilities.

This research employs a qualitative case study approach, with a sample of ten hospitals examined through interviews with senior management, executives and healthcare facilities managers. Relevant data was also collected from literature and analysed through critical appraisal and content analysis. The research methodology is based on the use of grounded theory research methodologies to build theories from case studies.

The research developed three integrated conceptual strategic frameworks for managing hospitals and healthcare facilities towards energy efficiency, green hospital initiatives and corporate governance. The research also outlined the concepts of green hospitals and energy efficiency management systems and best practices based on the conclusions drawn from the investigated case studies.

The study is limited to the initiatives and experiences of the healthcare facilities studied in the Middle East and North Africa (MENA) region.

The research findings, conclusions, recommendations and proposed frameworks and concepts contribute significantly to the existing body of knowledge. This research also provides recommendations for hospital managers and policymakers on how to effectively implement and manage energy efficiency initiatives in healthcare facilities.