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Healthcare systems are under pressure to improve their performance, while at the same time facing severe resource constraints, particularly workforce shortages. By applying resource-dependency-theory (RDT), we explore how healthcare organizations in different settings perceive pressure arising from uncertain access to resources and examine organizational strategies they deploy to secure resources.

A cross-sectional survey of key decision-makers in different healthcare settings in the metropolitan area of Cologne, Germany, on perceptions of pressure arising from the environment and respective strategies was conducted. For comparisons between settings radar charts, Kruskal–Wallis test and Fisher–Yates test were applied. Additionally, correlation analyses were conducted.

A sample of n = 237(13%) key informants participated and reported high pressure caused by bureaucracy, time constraints and recruiting qualified staff. Hospitals, inpatient and outpatient nursing care organizations felt most pressurized. As suggested by RDT, organizations in highly pressurized settings deployed the most vociferous strategies to secure resources, particularly in relation to personnel development.

This study is one of the few studies that focuses on the environment's impact on healthcare organizations across a variety of settings. RDT is a helpful theoretical foundation for understanding the environment's impact on organizational strategies. The substantial variations found between healthcare settings indicate that those settings potentially require specific strategies when seeking to address scarce resources and high demands. The results draw attention to the high level of pressure on healthcare organizations which presumably is passed down to managers, healthcare professionals, patients and relatives.

The purpose of this study is to investigate the implementation of a novel organizational structure in a specialized hospital department. The key issue was to optimize the efficacy of the process “hospital treatment” in a patient‐oriented approach.

A new organizational concept, i.e. the Cologne Consultant Concept (CCC), was developed by and implemented at the Department of Neurology, Cologne University Hospital in August 2007. The outcome of this reorganization was evaluated via a number of critical performance parameters (effects on daily routines and performance data, feedback from quality control and house officers). Furthermore, the strengths and weaknesses of this novel system were compared to the traditional ward‐based system in Germany, the Anglo‐American consultant model and care provided by sub‐specialized teams.

The reorganization of the healthcare services by the CCC provided flexible medical care for inpatients. The independent assignment of patients to a ward, and to a team of physicians offered incentives for case‐oriented and efficient medical treatment. Importantly, the time‐consuming admission process could be distributed evenly between physicians in chronological order. Furthermore, beneficial effects on the department's overall performance compared to the traditional ward‐based system were observed.

The CCC constitutes a valuable new organizational structure that can provide medical care in any specialized hospital department.

Hospital managers are confronted with decisions that have to account for multiple objectives, which may be in conflict with regard to efficiency and quality of care. In empirical studies occupancy and staffing ratios as well as in‐hospital mortality are frequently used measures for efficiency and quality‐of‐care, respectively. Efficiency and quality measures vary on a daily basis. However, most empirical studies fail to take this variation into account, especially because data of daily staffing levels are lacking. The paper seeks to exploit the notion that staffing levels are planned according to expected occupancy levels, i.e. estimated daily occupancy levels account for unobserved daily staffing levels.

Using administrative data from 2004 for a sample of 62 departments in 33 German hospitals, the relation between daily occupancy levels and in‐hospital mortality count on the department level is analyzed. In an OLS‐framework the paper estimates daily occupancy level for all departments and then uses the predicted occupancy levels in a zero‐inflated Poisson (ZIP) regression framework to explain in‐hospital mortality count.

The results show a potential trade‐off relation between predicted occupancy rates and mortality. More specifically, the paper finds that the trade‐off relation is less pronounced in hospitals with a higher number of available staff per bed.

First, the paper shows evidence for a negative trade‐off between measures of managerial and medical performance on a day‐to‐day basis. Second, interactions between single measures of efficiency are modeled, namely predicted occupancy rate and staff per bed ratios, and policy implications are developed. Third, first empirical results in this respect using German data are presented.

In this chapter, we assume the following: (1) the root cause of most organizational problems is culture and leadership, (2) executives seldom want to deal with these root causes, (3) because life is uncertain, organizational change is an emergent process, (4) most change processes unfold by reconstructing social reality, (5) the change process is inherently relational, (6) effective change efforts are enhanced by increasing the virtue of the actors, (7) change is embedded in the learning that flows from high-quality relationships, and (8) change agents may have to transcend conventional, economic exchange norms in order to demonstrate integrity and to build trust and openness. Drawing on the field of positive organizational scholarship, we focus on the change agent. We review the literature on self-change and offer several paths for becoming a positive leader.

We are living in turbulent and uncertain times and organizations need to struggle with these circumstances in order to achieve their goals. More than ever, resilience capacity is an added value that organizations need to build to respond to obstacles in these challenging times. Resilience is a capacity of individuals, teams, organizations, communities, even society, that make them to overcome setbacks (such crises, changes, or turbulences) in a way that they not only survive but emerge even stronger. Previous research on resilience at different range of settings and groups show that resilience is a capacity that can be trained or build up. Therefore, the goal of this chapter is to review the main lines of action available to organizations that want to foster resilience at work. The chapter will review theoretical research on workplace resilience, and empirical research that links Human Resources Management and workplace resilience. Aspects covered include the role that corporate social responsibility toward employees, career development or work–family balance have in developing resilience. The chapter closes with a discussion of some practical guidelines for HR managers and practitioners.

In view of the emphasis in cross-cultural research on negative factors such as cultural misfit, cultural distance, and the liability of foreignness, the purpose of this paper is to offer one explanation for why this is the case and highlight the advantages of giving at least equal emphasis to research on positive factors. Three propositions are offered to guide future cross-cultural research.

Summaries of empirical studies on the inherent inclinations of human systems toward the negative, as well as inclinations toward the positive, produce explanations for each of these biases and their implications for cross-cultural scholarship.

By prioritizing positive factors instead of negative factors, individuals and organizations perform at much higher levels than when the reverse is the case. Virtuous practices, in particular, are associated with positively deviant performance. Inasmuch as virtuousness is universally valued, its emphasis can address some of the liabilities of difference inherent in cross-cultural contexts.

The three propositions offered in the paper explain why negative biases exist, how positive biases provide an advantage to individuals and organizations, and highlight future directions for cross-cultural research. Social scientists have been challenged to help enable 51 percent of the world’s population to flourish by mid-century, and prioritizing positive cross-cultural phenomena is one prescription for achieving that objective.

Medical education was challenged and re-imagined during the COVID-19 pandemic. This study aims to examine the consequent changes in medical school curricula alongside students’ mental and physical health.

It is observed that 549 medical students (response rate: 79.7%) from 31 of 37 public medical schools in Germany completed a cross-sectional online survey. Students answered questions regarding teaching, internet use, COVID-19 and well-being. A multivariate logistic regression examined factors associated with depressed mood, insomnia and headache.

Academic teaching moved to a virtual environment (91%), whilst practical activities were suspended or cancelled (88%). Virtual teaching modality, quantity and quality were well-perceived, yet 35% of respondents were dissatisfied with their internet connection. Consequently, students worried about the pandemic’s adverse effect on their quality as a doctor (60%) and thought about postponing their studies (30%). Students were frequently engaged in the treatment of COVID-19 patients (36%). Daily screen time was significantly associated with depressed mood, insomnia and headache. Negative changes in mental and physical health were frequently observed.

Students’ experience with digital education during the COVID-19 pandemic was mixed. Whilst teaching modality, quantity and quality were well-perceived, students’ mental and physical health deteriorated. Further longitudinal studies investigating the impact of digital education on students’ well-being are necessary.

Besides teaching, faculties must quickly digitalize and strengthen social communities and offer targeted support services for students.

This is the first cross-sectional survey exploring medical students’ experience with virtual medical teaching alongside their mental and physical well-being in Germany.