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When designing an optimization model for use in a mass casualty event response, it is common to encounter the heavy and considerable demand of injured patients and inadequate resources and personnel to provide patients with care. The purpose of this study is to create a model that is more practical in the real world. So the concept of “predicting the resource and personnel shortages” has been used in this research. Their model helps to predict the resource and personnel shortages during a mass casualty event. In this paper, to deal with the shortages, some temporary emergency operation centers near the hospitals have been created, and extra patients have been allocated to the operation center nearest to the hospitals with the purpose of improving the performance of the hospitals, reducing congestion in the hospitals and considering the welfare of the applicants.

The authors research will focus on where to locate health-care facilities and how to allocate the patients to multiple hospitals to take into view that in some cases of emergency situations, the patients may exceed the resource and personnel capacity of hospitals to provide conventional standards of care.

In view of the fact that the problem is high degree of complexity, two multi-objective meta-heuristic algorithms, including non-dominated sorting genetic algorithm (NSGA-II) and non-dominated ranking genetic algorithm (NRGA), were proposed to solve the model where their performances were compared in terms of four multi-objective metrics including maximum spread index (MSI), spacing (S), number of Pareto solution (NPS) and CPU run-time values. For comparison purpose, paired t-test was used. The results of 15 numerical examples showed that there is no significant difference based on MSI, S and NPS metrics, and NRGA significantly works better than NSGA-II in terms of CPU time, and the technique for the order of preference by similarity to ideal solution results showed that NRGA is a better procedure than NSGA-II.

The planning horizon and time variable have not been considered in the model, for example, the length of patients’ hospitalization at hospitals.

Presenting an effective strategy to respond to a mass casualty event (natural and man-made) is the main goal of the authors’ research.

This paper strategy is used in all of the health-care centers, such as hospitals, clinics and emergency centers when dealing with disasters and encountering with the heavy and considerable demands of injured patients and inadequate resources and personnel to provide patients with care.

This paper attempts to shed light onto the formulation and the solution of a three-objective optimization model. The first part of the objective function attempts to maximize the covered population of injured patients, the second objective minimizes the distance between hospitals and temporary emergency operation centers and the third objective minimizes the distance between the warehouses and temporary centers.

The purpose of this paper is to analyse the role of hospital leaders and high-performance work practices (HPWPs) in intensive care units (ICUs) in organizational agility and its impact on healthcare personnel satisfaction.

This study was carried out in three ICUs of an important Spanish public hospital, one for adults, one paediatric and one neonatal. The unit of analysis was ICUs personnel (324 individuals: 14.5%, 48.8% and 36.7% from the categories of doctors, nurses and nurses' aides, respectively) who were invited to participate in the study. The sample had 248 individuals, with a sampling distribution by categories that was quite similar to that of the population. To test the hypotheses proposed, structural equations modeling (SEM) were used as the maximum likelihood estimation method.

The results confirm the proposed model and reveal the importance of the human dimension in ICUs on hospital agility and performance in terms of satisfaction of the clinical staff working in this area.

This paper is original because it analyses units of high complexity, such as ICUs from a management and non-clinical perspective. In addition, it studies the role of hospital managers and HPWPs on employee outcomes, as well as in-hospital responsiveness in a very dynamic context that demands agility on the management approach.

Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) is being widely promoted in healthcare settings to train staff in evidence-based approaches that promote patient safety. It involves a comprehensive curriculum that spells out key principles and actionable tools for a culture change toward patient-safety-focussed teamwork. Activities begin with selected personnel attending TeamSTEPPS Master Trainer Training (MTT) and then organizing and providing TeamSTEPPS training for staff in their organization. The authors conducted interviews with respondents at community hospitals conducting TeamSTEPPS staff training. To structure the interviews, the authors used 11 key questions identified by Weaver et al. in their in-depth team training literature review. The purpose of this paper is to examine approaches taken by community hospital personnel and compare those to the best practices recommended by Weaver et al.

The authors interviewed 57 staff and administrators at 22 community hospitals sending teams to TeamSTEPPS MTT.

The authors find that training implementation in community hospitals differs significantly from the established, research-based principles for effective team training described in the research literature, which is largely based in academic medical centers.

The current findings suggest that several TeamSTEPPS training features could be enhanced in community hospitals including: choosing staff who have the skills to be effective trainers in this train-the-trainer model; emphasizing active learning; and sustaining lessons through on-the-job application, practice and feedback. These principles apply to many training approaches employed in small healthcare organizations.

This study aims to increase the understanding of the starting points and presuppositions of organizational learning (OL) processes in a hospital’s surgical department based on the existing theory of OL and to make visible the practical possibilities of the theory in this context.

The study was conducted as a case study. The data were collected from personnel of the hospital’s surgical department and consisted of 26 thematic interviews. The data were analyzed using qualitative theory-driven content analysis.

This study found different starting points for both employee-oriented and organization-oriented learning processes that could potentially progress to different levels of the organization: from individuals to a wider group or from a large group to an individual. The starting point of employee-oriented learning processes was depicted as everyday life problems or situations or was based on the person’s interest. The starting points of organization-oriented learning processes were described as achieving or maintaining the organization’s expected skill levels, pursuing continuous development or pursuing the organization’s specific development needs. Different kinds of presuppositions were also located within the OL processes.

This study produced new practice-based knowledge about the starting points of OL processes and their presuppositions. In health-care organizations, learning is especially important due to intensive and complex changes, and this study provides empirical evidence on how to enhance learning.

Today, quality management systems (QMS) are a promising candidate for the improvement of healthcare services. The purpose of this paper is to investigate the opinions/attitudes of gynecology healthcare professionals toward quality and quality management in healthcare facilities (HFs) in Greece.

An anonymous self-administered questionnaire was distributed to healthcare professionals, asking for opinions on quality objectives associated with the everyday workflow in HFs (e.g. management of patients, resources, etc.) and on QMS. The study was conducted in Hippokration Hospital of Thessaloniki, including 187 participants. Statistical assessment and analysis of the questionnaires were carried out.

Although 87.5 percent recognized the importance of potential QMS implementation and accreditation, over 50 percent believed that it would lead rather to increased workload and bureaucracy than to any considerable quality improvement. More than 60 percent were completely unaware of the implementation of quality objectives such as quality handbook, quality policy, audit meetings and accreditation status in their HFs. This unawareness was also reported in terms of patient, data, human and general resources management. Finally, awareness over medical malpractice and positive attitude toward official reporting were detected.

Most respondents acknowledged the significance of quality, QMS implementation and accreditation in Greek hospitals. However, there was a critical gap in knowledge about quality management objectives/processes that could be possibly resolved by expert teams and well-organized educational programs aiming to educate personnel regarding the various quality objectives in Greek HFs.

The aim of this article is to examine the differences in service quality between public and private hospitals in Turkey.

This study applies the principles behind the SERVQUAL model and compares Turkey's public and private hospital care service quality. The study sample contains a total of 200 outpatients. Through the identification of 40 service quality indicators and the use of a Likert‐type scale, two questionnaires containing 80‐items was developed. The former measured patients' expectations prior to admission to public and private hospital service quality. The latter measured patient perceptions of provided service quality.

The results indicate that inpatients in the private hospitals were more satisfied with service quality than those in the public hospitals. The results also suggest that inpatients in the private hospitals were more satisfied with doctors, nurses and supportive services than their counterparts in the public hospitals. Finally, the results show that satisfaction with doctors and reasonable costs is the biggest determinants of service quality in the public hospitals.

Consequently, SERVQUAL, as a standard instrument for measuring functional service quality, is reliable and valid in a hospital environment.

The purpose of this paper is to provide an overview concerning employer brand image in a Finnish hospital organization. What is done for recruitment marketing? This study offers some proposals for improving the recruitment process.

The research is a qualitative case study and the research method used is a group interview. The research questions are approached from an organizational perspective. Background information about the current labour shortage in health care is gathered from the focus hospital organization, from the public media and from the health care trade organizations.

Very few marketing actions concerning employer image have been done in the focus hospital. There also existed a lack of appropriate recruitment tools and competence. Data systems and the internet have not been fully exploited in the recruitment process. Vacancies are not announced in educational institutes. Career development possibilities are not presented in job advertisements and job‐rotation has not been used in recruitment.

This paper provides useful information for health care managers and researchers concerning the role of employer image in recruiting and the importance of a well‐organized recruitment process.

The purpose of this research is to investigate the practices of the interim and current CEOs employed in managing a supportive environment conducive for learning as well as sustaining organizational change; and second, to describe the theory of practice guiding their efforts.

An action science approach, coupled with the case‐study data‐gathering method to enable a pragmatic grounding of the change processes and organizational learning.

A theory of practice defined as three process principles of power that aid in managing a supportive environment conducive for learning as well as organizational change.

The theory of practice set forth combines two advocated views in using power (position power and empowerment) into a framework of reciprocal‐relational power. The theory needs to undergo further research to test its applicable knowledge in an action context.

Potential guide in helping practitioners in recognizing and implementing processes of reciprocal‐relational power to improve organizational learning and the success of change.

The paper presents a new way to recognize and see reciprocal‐relational forces within a cultural‐social‐political context.

The purpose of this paper is to identify the main reasons for discharge against medical advice (DAMA) in the emergency department (ED) of a teaching hospital in Tehran, Iran.

This cross-sectional study was conducted on all the patients who left the ED of a referral teaching hospital against medical advice (AMA) in 2008. A questionnaire was filled out for each patient to determine the reasons behind patient leaving AMA.

In total, 12.8 percent of the patients left the hospital AMA. Dissatisfaction with being observed in the ED, having a feeling of recovery and hospital personnel encouraging patients to leave the hospital were the main reasons for leaving the hospital AMA.

Like many other centers, the results showed that poor communication skill and work overload were the main contributing factors to DAMA. The center managed to improve patient satisfaction and thus lowered DAMA rates following this study. Considering the similarities reported in the reports and that of other studies, it could be concluded that policy makers in other centers can also benefit from the results to adopt effective approaches to reduce DAMA rate.

To the knowledge no study has evaluated the rate and the reasons behind DAMA in the Iranian EDs.

Drawing on normal accident and high-reliability organizational theories, this study examines the impact of magnitude and likelihood of disruptions on surgical procedure performance. More importantly, the authors investigate the moderating role played by information exchange and risk management infrastructure in mitigating the negative effect of disruption on performance.

A nationwide multi-respondent survey was administered to operating room personnel to collect information on their experiences with disruptions experienced in surgeries. The survey data are analyzed to examine the relationship between operational disruptions and procedure performance. Additionally, the moderating roles of risk management infrastructure and information exchange on the relationship between disruptions and performance are investigated. The results obtained from the empirical analysis are validated using data from an ethnographic investigation of surgeries at a major hospital.

The results show that both the magnitude and the likelihood of a disruption adversely impact procedure performance. Interestingly, the authors find that risk management infrastructure and information exchange play different roles in mitigating the effect of disruptions on performance. The authors find that while risk management infrastructure helps mitigate the effect of magnitude of service disruptions, information exchange helps reduce the effects of likelihood of disruptions. The findings lend strong support to the theoretical assertions. By means of the participant–observer data collected from over 100 surgeries as part of the ethnographic investigation, the authors validate the key findings. The findings suggest that disruptions are common occurrences in surgical settings, but their performance impact may be lessened or altogether avoided with the proper information and risk management mechanisms in place.

This survey research extends the understanding of risk management by considering a context that is highly prone to disruptions. The authors adopt existing constructs pertaining to supply chain disruptions within this context and find new insights. The findings of the study show differential roles played by information exchange and risk management infrastructure in mitigating disruptions. This nuanced understanding provides directions for aligning efforts towards risk mitigation in surgical settings in a more focused way. This study supplements findings from survey data analysis with an examination of data collected by means of ethnographic investigation.