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This research aims to investigate the influence of building design on the thermal comfort of occupants of naturally ventilated hospital (NVH) wards to identify the aspects with the most significant influence on the thermal comfort of hospital buildings during the hot-dry season in the hot-humid tropics of Southeast Nigeria.

Field measurements, physical observations and a questionnaire survey of 60 occupants of the wards of the Joint Presbyterian Hospital, Uburu in Ebonyi State, Nigeria were undertaken. The data were analysed using Humphreys' neutral temperature formula, descriptive statistics and multiple regression analysis.

The results revealed that the neutral temperature for the wards ranges from 26.2 °C to 29.9 °C, the thermal condition in the wards was not comfortable because it failed to meet the ASHRAE Standard 55 as only 65% of the occupants said the thermal condition was acceptable. The number and sizes of windows, building orientation, the presence of high-level windows and higher headroom significantly influenced the occupants' thermal comfort vote.

This research is valuable in estimating comfort temperature and identifying aspects that require attention in enhancing the capacity of NVH wards to effectively meet the thermal comfort needs of occupants in the hot-humid tropics of Southeast Nigeria and other regions that share similar climatic conditions.

To the best of the authors’ knowledge, this is the first study of this nature that provides valuable feedback for building design professionals on the performance of existing hospital buildings in meeting users' thermal comfort needs in the hot-dry season of the hot-humid tropics in Southeast Nigeria.

The most challenging aspect of hospital design is the creation of an environment that heals rather than the one acting as a barrier to healing. Much has not been done in the aspect of ascertaining the level of impact “indoor environmental quality (IEQ)” has on building occupants in healthcare facilities. Therefore, this study aims to investigate the impact of IEQ on patients' health and well-being.

The study investigates the hypothesis that four IEQ parameters (thermal quality, acoustic quality, lighting quality and indoor air quality [IAQ]) influence patients' overall satisfaction with the performance of hospital wards. Questionnaire responses were sought from the patients as the main occupants of hospital ward buildings. A proposed weighted structural model for IEQ establishing the relationship between IEQ parameters, patients' overall satisfaction and patients' health outcome was analyzed using structural equation modeling (SEM).

The most influential IEQ parameters on patients' overall satisfaction with IEQ in hospital wards are thermal quality, IAQ and lighting quality. The findings from this study revealed that the parameters of influence on patients' overall satisfaction and health outcomes vary with hospital ward orientation and design configuration.

This study has explored the need for the integration of all factors of IEQ at the building design stage towards providing a hospital environmental setting that reflects occupants' requirements and expectations and also promotes patient healing processes. This should be the focus of architects and healthcare managers and providers.

While there is considerable anecdotal evidence and some research indicating poor nutritional intake and high levels of food wastage in hospitals, there have been no studies relating these issues to the catering system used. The overall purpose of this study was, therefore, to measure food wastage and nutritional intake in selected hospital catering systems. Data were collected from three types of ward (elderly, medical and surgical) in four hospitals (nine wards), two in London and two in Southern England. Three wards used food cooked mainly in the hospital kitchen, six used cook‐chill and cook‐freeze dishes bought in ready prepared. Five of the wards used a bulk system where food is transported to the ward and plated, in the others, food is plated in the hospital kitchen then transported to the ward. Food sent to the ward, served to patients, and that which remained uneaten or left on the service trolley was weighed for a minimum of 24 hours in each ward; 966 patient‐meal‐days. This data enabled food wastage and nutritional intake to be calculated. Results indicate that food wastage was lower at the breakfast meal, than the midday and evening meal, 23.10 per cent, 39.99 per cent and 42.35 per cent, respectively; female wastage was higher than male, 33.91 per cent and 27.26 per cent, respectively; wastage was higher where food was plated in wards rather than in the kitchen, 57.75 per cent and 35.28 per cent, respectively; and wastage was higher where food was purchased‐in ready prepared, rather than prime cooked in the hospital kitchen. Nutritional intake was calculated for five wards and in all, energy intake was below the recommendations, the highest deficit being 58 per cent. Deficiencies were also noted for other nutrients.

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.

The purpose of this paper, in the context of hospital wards, is to test a model in which the ward manager's orientation towards a given organizational climate contributes to determine the climate perceived by medical and nursing staff, and this, in turn, has an impact on patient satisfaction.

The design of the study is cross‐sectional. The manager's climate orientation, employee perceptions of organizational climate, and patient satisfaction questionnaires were administered to ward managers, medical staff, and inpatients in 57 wards belonging to ten public hospitals in Italy. The hypothesised model was tested using two‐level structural equation modelling.

Different climates impact on patient satisfaction in a different way. Evidence was found that a human relation climate augments patient satisfaction. Ward managers' orientation on specific organizational models is matched by the actual climate perceived by medical and nursing staff. Comparison between alternative nested models shows that there is evidence in favour of the mediating effect of climate between the managers' climate orientation and patient satisfaction.

The main limitation of the paper is the cross‐sectional nature of the data set, which does not allow for definitive conclusions on the direction of causality links.

Understanding the link between climate and patient satisfaction may guide hospitals towards a more conscious selection of the appropriate organizational model.

The contribution of the present paper to the extant literature is twofold. First, it verifies whether the ward manager's climate orientation is matched by the organizational climate as perceived by subordinates. Second, it investigates the mediating role that organizational climate plays between ward managers' orientations and patient satisfaction.

The purpose of this paper is to explore the nature and impact of leadership in relation to the local implementation of quality improvement interventions in health care organisations.

Using empirical data from two studies of the implementation of The Productive Ward: Releasing Time to Care™ in English hospitals, the paper explores leadership in relation to local implementation. Data were attained from in-depth interviews with senior managers, middle managers and frontline staff (n=79) in 13 NHS hospital case study sites. Framework Approach was used to explore staff views and to identify themes about leadership.

Four overall themes were identified: different leadership roles at multiple levels of the organisation, experiences of “good and bad” leadership styles, frontline staff having a sense of permission to lead change, leader's actions to spread learning and sustain improvements.

This paper offers useful perspectives in understanding informal, emergent, developmental or shared “new” leadership because it emphasises that health care structures, systems and processes influence and shape interactions between the people who work within them. The framework of leadership processes developed could guide implementing organisations to achieve leadership at multiple levels, use appropriate leadership roles, styles and behaviours at different levels and stages of implementation, value and provide support for meaningful staff empowerment, and enable leader's boundary spanning activities to spread learning and sustain improvements.

In the year 2000, the UK government promoted the concept that hospital services be shaped around the needs of the patient to make their stay in hospital as comfortable as possible and advocated the introduction of a ward housekeeper role in at least 50 per cent of hospitals by 2004. This is a ward‐based non‐clinical role centred on cleaning, food service and maintenance to ensure that the basics of care are right for the patient. In 2002 the Facilities Management Graduate Centre at Sheffield Hallam University completed a series of six case studies looking at the role within different NHS Trusts. These were developed through interviews and observations with the facilities manager, ward housekeepers and nursing staff and also by collecting documentary evidence such as job descriptions, financial details and training information. Common themes were identified, relating to experiences of developing and implementing the ward housekeeper role. This paper suggests models of best practice relating to role, recruitment, induction, training, integration and management.

The purpose of this paper is to understand how the hospital staff (nurses and physicians) at two hospital wards have coped with everyday work having leaders in conflict or longer periods without one or the other leader and whether the way the staff handled the challenges was resilient.

Through semi-structured interviews with the staff at the two wards, the authors analysed how the staff were working, if they had cooperation and interdisciplinary cooperation, how they would handle uncertainties and how they coped with the absence of their leaders.

The staff at both wards were handling the everyday work in a resilient way. The authors argue that to increase the resilience in an organisation, leaders should acknowledge the need to establish strong emotional ties among staff and at the same time ensure role structures that make sense in the everyday work.

This study reports on original work and shows what decision makers could do to increase resilience in an organisation. This paper shows that the organisational context is important for the staff to act resiliently. As leaders come and go, it can be important for the stability of the organisation to promote the staff in acting resiliently independent of the leader situation.

While transition programs are widely used to facilitate newly graduated nurses transition to healthcare settings, knowledge about preconditions for implementing such programs in the hospital context is scarce. The purpose of this study was to explore program coordinators’ perspectives on implementing a transition program for newly graduated nurses.

An explorative qualitative study using individual interviews. Total of 11 program coordinators at five acute care hospital administrations in a south-west region in Sweden. Data was subjected to thematic analysis, using NVivo software to promote coding.

The following two themes were identified from the analysis: Create a shared responsibility for introducing newly graduated nurses, and establish legitimacy of the program. The implementation process was found to be a matter of both educational content and anchoring work in the hospital organization. To clarify the what and why of implementing a transition program, where the nurses learning processes are prioritized, was foundational prerequisites for successful implementation.

This paper illustrates that implementing transition programs in contemporary hospital care context is a valuable but complex process that involves conflicting priorities. A program that is well integrated in the organization, in which responsibilities between different levels and roles in the hospital organization, aims and expectations on the program are clarified, is important to achieve the intentions of effective transition to practice. Joint actions need to be taken by healthcare policymakers, hospitals and ward managers, and educational institutions to support the implementation of transition programs as a long-term strategy for nurses entering hospital care.

This research aims to investigate the implementation of the new ward housekeeper role in a hospital setting. The purpose is to propose a model to demonstrate how facilities management (FM) departments and clinical ward teams work together effectively to deliver catering and cleaning services.

The context of the implementation of the role was deemed a necessary feature, particularly to understand the organisational structures. In this case, the context was a hospital, and the underlying mechanisms that were in place included local recruitment and retention issues. Therefore, an interpretive approach was taken, and a series of semi-structured interviews was the primary method to collect data, supplemented by some non-participant observation and document analysis.

The findings from the two themes enable the development of a model to illustrate the working relationships between FM departments and clinical ward teams.

The findings from the study are of significance for hospital facilities and estates departments and clinical stakeholders who have the responsibility of ward catering, cleaning and the environment.

The significance of this study emerges through the advancement of methodology within the context of facilities in health care and through the contribution to knowledge and practice as a result of the proposed mode. This was the first type of study to look in detail at ward housekeeping models, using an interpretive approach over a relatively long period of time.