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This paper brings attention to the role of hybrid middle managers. In particular it explores the relationship of organisational purpose and role requirements.

The primary research question for the original research was: What does it mean to hybrid managers to lead and deal with imposed changes (restructuring) to services? A novel narrative approach based on a synthesis of Czarniawska, Gabriel and Boje was applied. Accounts from interviews were condensed into narratives by initially using the categories defined by Gabriel (2000) as epic, tragic, comic and romantic and then further categorised into stories, themes and a serial (Czarniawska, 1997). The final stage of the three-way synthesised narrative approach incorporated Boje’s (2001) notion of “antenarrative” to include pre-emplotment elements.

Four narratives are provided that give insight to the nature of the struggles the hybrid middle managers were in the midst of. A struggle to address incongruent demands being placed on them that cause tension with their sense of purpose, organisational goals and their hybrid clinical roles and management roles. In the midst of these struggles the narratives illustrate the dynamic of ethical resistance that seeks a way forward. However, this appears to come at a health and well-being cost to the middle managers.

The paper offers up the notion of an added third bind to the traditional double, that of “ethical resistance”, a struggle to align organisational purpose with clinical and management role requirements. Theorising this third bind provides a new insight into understanding the context and dynamics of the hybrid middle manager role and behaviour. Indeed, the idea of ethical resistance may cause a revision of how resistance is understood.

This work aims to integrate the concepts generated by a systematic literature review on patient flows in emergency departments (ED) to serve as a basis for developing a generic process model for ED.

A systematic literature review was conducted using PRISMA guidelines, considering Lean Healthcare interventions describing ED patients’ flows. The initial search found 141 articles and 18 were included in the systematic analysis. The literature analysis served as the basis for developing a generic process model for ED.

ED processes have been represented using different notations, such as value stream mapping and workflows. The main alternatives for starting events are arrival by ambulance or walk-in. The Manchester Triage Scale (MTS) was the most common protocol referred to in the literature. The most common end events are admission to a hospital, transfer to other facilities or admission to an ambulatory care system. The literature analysis allowed the development of a generic process model for emergency departments. Nevertheless, considering that several factors influence the process of an emergency department, such as pathologies, infrastructure, available teams and local regulations, modelling alternatives and challenges in each step of the process should be analysed according to the local context.

A generic business process model was developed using BPMN that can be used by practitioners and researchers to reduce the effort in the initial stages of design or improvement projects. Moreover, it’s a first step toward the development of generalizable and replicable solutions for emergency departments.

The purpose of this paper is to examine patient engagement in remote consultation services, an increasingly important issue facing Healthcare Operations Management (HOM) given the significant expansion in this and other forms of telehealth worldwide over the last decade. We use our analysis of the literature to develop a comprehensive framework that incorporates the patient journey, multidimensionality, antecedents and consequences, interventions and improvement options, as well as the cyclic nature of patient engagement. We also propose measures suitable for empirical assessment of different aspects of our framework.

We undertook a comprehensive review of the extant literature using a systematic review approach. We identified and analysed 63 articles published in peer-reviewed scientific journals between 2003 and 2022.

We conceptualise patient engagement with remote consultation across three key aspects: dimensions, process, and the antecedents and consequences of engagement. We identify nine contextual categories that influence such engagement. We propose several possible metrics for measuring patient engagement during three stages (before service, at/during service and after service) of remote consultation, as well as interventions and possible options for improving patient engagement therein.

The primary contribution of our research is the development of a comprehensive framework for patient engagement in remote consultation that draws on insights from literature in several disciplines. In addition, we have linked the three dimensions of engagement with the clinical process to create a structure for future engagement assessment. Furthermore, we have identified impact factors and outcomes of engagement in remote consultation by understanding which can help to improve levels of adoption, application and satisfaction, and reduce healthcare inequality. Finally, we have adopted a “cyclic” perspective and identified potential interventions that can be combined to further improve patient engagement in remote consultation.

The purpose of this mixed-methods study was to explore how medical secretaries experience digital transformation in a Swedish healthcare organisation, with a focus on workplace climate and health.

Data were collected using a sequential exploratory mixed-methods design based on grounded theory, with qualitative data collection (a Quality Café and individual interviews) followed by quantitative data collection (a questionnaire).

Four categories with seven underlying factors were identified, emphasising the crucial need for effective organisation of digital transformation. This is vital due to the increased knowledge and skills in utilising technology. The evolving roles and responsibilities of medical secretaries in dynamic healthcare settings should be clearly defined and acknowledged, highlighting the importance of professionality. Ensuring proper training for medical secretaries and other occupations in emerging techniques is crucial, emphasising equal value and knowledge across each role. Associations were found between some factors and the health of medical secretaries.

This study adds to the knowledge on digital transformation in healthcare by examining an important occupation. Most data were collected online, which may be a limitation of this study.

Several aspects of the medical secretaries’ experiences were identified. Knowledge of these is valuable for healthcare managers to make digital transformation more effective while avoiding excessive strain on medical secretaries.

Medical secretaries are expected to contribute to the digitalisation of healthcare. However, minimal research has been conducted on the role of medical secretaries in workplace digitalisation, focusing on workplace roles and its dynamics.

This paper aims to strengthen the connection between therapeutic built environments and tourism research and practice. While there is evidence in the importance of the Built Environment (BE) of cities, workspaces and health-care facilities to health, the BE of facilities for tourism in relation to health remains relatively unexplored.

The paper conducts an exploratory search on architecture and tourism BE and narrowed it down to a scoping review on wellness tourism and architectural health impacts from 2010 to 2024. This would highlight lessons learned from the field of medical architecture, i.e. a cross-disciplinary field combining BE research, public health and health-care services research, to explore potential synergies of cross-pollination with the field of hospitality and medical architecture.

Principles and theories of medical architecture can be incorporated into the BE of wellness hospitality, tourism for ageing and pandemic preparedness.

The paper sets the basis of a novel cross-disciplinary collaboration between therapeutic architecture and hospitality for increasing the societal impact of the latter. This is particularly important in a post-Covid and an ageing society.

本文旨在加强治疗性建筑环境与旅游研究和实践之间的联系。虽然有证据表明城市、工作场所和医疗设施的建筑环境(BE)对健康很重要, 但与健康相关的旅游设施的建筑环境仍相对未被探索。

作者对建筑和旅游建筑环境进行了探索性搜索, 并将其缩小到2010年至2024年期间的健康旅游和建筑健康影响的范围审查。这将突出医疗建筑领域的经验教训, 即结合建筑环境研究、公共卫生和医疗服务研究的跨学科领域, 以探索与酒店业和医疗建筑领域交叉授粉的潜在协同效应。

医疗建筑的原则和理论可以纳入健康酒店业、老龄化旅游和大流行病准备的建筑环境中。

我们为治疗性建筑和酒店业之间的新型跨学科合作奠定了基础, 以增加后者的社会影响。这在后疫情时代和老龄化社会中尤为重要。

Este documento pretende reforzar la conexión entre los entornos construidos terapéuticos y la investigación y la práctica del turismo. Aunque existen pruebas de la importancia del entorno construido (EC) de las ciudades, los espacios de trabajo y las instalaciones sanitarias para la salud, el EC de las instalaciones para el turismo en relación con la salud sigue estando relativamente inexplorado.

Realizamos una búsqueda exploratoria sobre arquitectura y el EC turístico y la acotamos a una revisión de alcance sobre el turismo de bienestar y los impactos arquitectónicos en la salud desde 2010 hasta 2024. Esto pondría de relieve las lecciones aprendidas en el campo de la arquitectura médica, es decir, un campo interdisciplinar que combina la investigación de la EC, la salud pública y la investigación de los servicios sanitarios, para explorar posibles sinergias de polinización cruzada con el campo de la hostelería y la arquitectura médica.

Los principios y teorías de la arquitectura médica pueden incorporarse a la EC de la hosteleria para el bienestar, el turismo para el envejecimiento y la preparación ante pandemias.

Sentamos las bases de una novedosa colaboración interdisciplinar entre la arquitectura terapéutica y la hostelería para aumentar el impacto social de esta última. Esto es especialmente importante después de la crisis y en una sociedad que envejece.