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Society is critically dependent on an adequate supply of hospital doctors to ensure optimal health care. Voluntary turnover amongst hospital doctors is, however, an increasing problem for hospitals. The aim of this study was to systematically review the extant academic literature to obtain a comprehensive understanding of the current knowledge base on hospital doctor turnover and retention. In addition to this, we synthesise the most common methodological approaches used before then offering an agenda to guide future research.

Adopting the PRISMA methodology, we conducted a systematic literature search of four databases, namely CINAHL, MEDLINE, PsycINFO and Web of Science.

We identified 51 papers that empirically examined hospital doctor turnover and retention. Most of these papers were quantitative, cross-sectional studies focussed on meso-level predictors of doctor turnover.

Selection criteria concentrated on doctors who worked in hospitals, which limited knowledge of one area of the healthcare environment. The review could disregard relevant articles, such as those that discuss the turnover and retention of doctors in other specialities, including general practitioners. Additionally, being limited to peer-reviewed published journals eliminates grey literature such as dissertations, reports and case studies, which may bring impactful results.

Globally, hospital doctor turnover is a prevalent issue that is influenced by a variety of factors. However, a lack of focus on doctors who remain in their job hinders a comprehensive understanding of the issue. Conducting “stay interviews” with doctors could provide valuable insight into what motivates them to remain and what could be done to enhance their work conditions. In addition, hospital management and recruiters should consider aspects of job embeddedness that occur outside of the workplace, such as facilitating connections outside of work. By resolving these concerns, hospitals can retain physicians more effectively and enhance their overall retention efforts.

Focussing on the reasons why employees remain with an organisation can have significant social repercussions. When organisations invest in gaining an understanding of what motivates their employees to stay in the job, they are better able to establish a positive work environment that likely to promote employee well-being and job satisfaction. This can result in enhanced job performance, increased productivity and higher employee retention rates, all of which are advantageous to the organisation and its employees.

The review concludes that there has been little consideration of the retention, as opposed to the turnover, of hospital doctors. We argue that more expansive methodological approaches would be useful, with more qualitative approaches likely to be particularly useful. We also call on future researchers to consider focussing further on why doctors remain in posts when so many are leaving.

Despite advancements in construction digitalisation and alternative building technologies, cost overrun is still a challenge in the construction industry. The inflation rate is increasing, especially in developing countries, and is critical in cost overrun matters. It can deviate construction built-up rate components. This may thwart improving construction-related Sustainable Development Goals (SDGs). Studies concerning the impact of the inflation rate on construction-related SDGs are scarce in developing countries, including Nigeria. The study investigated the impact of inflation on Nigeria’s construction projects and their outcome on SDGs and suggested possible ways to improve achievement of construction-related SDGs and their targets.

The researchers employed a qualitative research design. This is because of the study’s unexplored dimension. The researchers engaged 35 participants across major cities in Nigeria via semi-structured virtual and face-to-face interviews. The research utilised a thematic method for collated data and accomplished saturation.

Findings reveal that the impact of inflation on construction projects, if not checked, could hinder achieving construction-related SDGs in Nigeria. This is because of the past three years of hyperinflation that cut across major construction components. It shows that the upward inflation rate threatens achieving construction-related SDGs and proffered measures to mitigate inflation and, by extension, enhance achieving construction-related SDGs. This includes a downward review of the Monetary Policy Rate, control of exchange rate volatility and addressing insecurity to restore FDIs and FPIs confidence.

Besides suggesting possible solutions to mitigate hyperinflation on construction components to improve achieving construction-related SDGs, findings will stipulate government policymakers put measures in place through favourable fiscal and monetary policy implementation and encourage moving from a consumption to a production nation.

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.

This work aims to analyse the relationship between public health efficiency and well-being considering a panel of 102 Italian provinces from 2000 to 2016 and evaluates if there are omitted variable biases and endogeneity biases and also evaluates if there are heterogeneous effects among provinces with different income levels.

We use a multi-input and output bootstrap data envelopment analysis to assess public health efficiency. Then, we measure well-being indices using the min-max linear scaling transformation technique. A two-stage least squares model is used to identify the causal effect of improving public health efficiency on well-being to account for time-invariant heterogeneity, omitted variable bias and endogeneity bias.

After controlling for important economic factors, the results show a significant effect of an accountable and efficient public health system on well-being. Those effects are concentrated in the North, the most economically, geographically and environmentally advantageous areas.

The use of the sample mean, probably the oldest and most used method for aggregating the indicators, could be affected by variable compensation, with consequent misleading results in the process of constructing the well-being index. Another limitation is the use of lagged values of the main predictor as an instrument in the instrumental variables setting because it could lead to information loss. Finally, the availability of data over a long period of time.

The findings could help policymakers adopt measures to strengthen the public health system, encourage private providers and inspire countries worldwide.

These results draw the attention of local authorities, who play an important role in designing and implementing policies to stimulate local public health efficiency, which puts individuals in the conditions of achieving overall well-being in their communities.

For the first time in Italy, a panel of well-being indices was constructed by developing new methodologies based on microeconomic theory. Furthermore, for the first time, the assessment of the relationship between public health efficiency and well-being is carried out using a panel of 102 Italian provinces.

The study’s purpose is to investigate the constraints and facilitators influencing skiing participation in Beijing. This research includes three segments based on the frequency of skiing participation (i.e. non-, low-frequency-, and high-frequency skiers). By doing so, the study offers an enhanced understanding of the Chinese skiing market and unveils insights assisting industry professionals to effectively address their customers' diverse needs and expectations.

An online survey was developed based on prior research and consisted of four sections: (1) skiing participation; (2) constraints; (3) facilitators; (4) demographics. Items in the constraint and facilitator scale were measured using a 7-point Likert scale. A total of 409 participants completed the survey. The participants included 137 non-skiers, 134 low-frequency skiers, and 138 high-frequency skiers.

Through an exploratory factor analysis, three constructs emerged: general constraints, facilitators and learning constraints. As expected, facilitators were a positive predictor of skiing participation. Importantly, the emergent construct of learning constraints was a negative predictor of skiing and yet, the construct of general constraints was insignificant. Furthermore, the three segments differ significantly in household status, income, and education level.

These results support previous research noting the relevance in skiing participation of the dimensions: facilitators and learning constraints. The findings point to the need for ski resorts in Beijing to offer instructional sessions for beginners so they may become familiar with skiing fundamentals and enhance their confidence, particularly among nonskiers and low-frequency skiers.

Healthcare providers are under pressure due to increasing and more complex demands for services. Increased pressure on budgets and human resources adds to an ever-growing problem set. Competent leaders are in demand to ensure effective and well-performing healthcare organisations that deliver balanced results and high-quality services. Researchers have made significant efforts to identify and define determining competencies for healthcare leadership. Broad terms such as competence are, however, inherently at risk of becoming too generic to add analytical value. The purpose of this study is to suggest a holistic framework for understanding healthcare leadership competence, that can be crucial for operationalising important healthcare leadership competencies for researchers, decision-makers as well as practitioners.

In the present study, a critical interpretive synthesis (CIS) was conducted to analyse competency descriptions for healthcare leaders. The descriptions were retrieved from peer reviewed empirical studies published between 2010 and 2022 that aimed to identify healthcare services leadership competencies. Grounded theory was utilised to code the data and inductively develop new categories of healthcare leadership competencies. The categorisation was then analysed to suggest a holistic framework for healthcare leadership competence.

Forty-one papers were included in the review. Coding and analysing the competence descriptions resulted in 12 healthcare leadership competence categories: (1) character, (2) interpersonal relations, (3) leadership, (4) professionalism, (5) soft HRM, (6) management, (7) organisational knowledge, (8) technology, (9) knowledge of the healthcare environment, (10) change and innovation, (11) knowledge transformation and (12) boundary spanning. Based on this result, a holistic framework for understanding and analysing healthcare services leadership competencies was suggested. This framework suggests that the 12 categories of healthcare leadership competencies include a range of knowledge, skills and abilities that can be understood across the dimension personal – and technical, and organisational internal and – external competencies.

This literature review was conducted with the results of searching only two electronic databases. Because of this, there is a chance that there exist empirical studies that could have added to the development of the competence categories or could have contradicted some of the descriptions used in this analysis that were assessed as quite harmonised. A CIS also opens for a broader search, including the grey literature, books, policy documents and so on, but this study was limited to peer-reviewed empirical studies. This limitation could also have affected the result, as complex phenomenon such as competence might have been disclosed in greater details in, for example, books.

The holistic framework for healthcare leadership competences offers a common understanding of a “fuzzy” concept such as competence and can be used to identify specific competency needs in healthcare organisations, to develop strategic competency plans and educational programmes for healthcare leaders.

This study reveals a lack of consensus regarding the use and understanding of the concept of competence, and that key competencies addressed in the included papers are described vastly different in terms of what knowledge, skills and abilities they entail. This challenges the operationalisation of healthcare services leadership competencies. The proposed framework for healthcare services leadership competencies offers a common understanding of work-related competencies and a possibility to analyse key leadership competencies based on a holistic framework.