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High-quality nursing home (NH) care has long been a challenge within the United States. For decades, policymakers at the state and federal levels have adopted and implemented regulations to target critical components of NH care outcomes. Simultaneously, our delivery system continues to change the role of NHs in patient care. For example, more acute patients are cared for in NHs, and the Center for Medicare and Medicaid Services (CMS) has implemented value payment programs targeting NH settings. As a part of these growing pressures from the broader healthcare delivery system, the culture-change movement has emerged among NHs over the past two decades, prompting NHs to embody more person-centered care as well as promote settings which resemble someone's home, as opposed to institutionalized healthcare settings.

Researchers have linked culture change to high-quality outcomes and the ability to adapt and respond to the ever-changing pressures brought on by changes in our regulatory and delivery system. Making enduring culture change within organizations has long been a challenge and focus in NHs. Despite research suggesting that culture-change initiatives that promote greater resident-centered care are associated with several desirable patient outcomes, their adoption and implementation by NHs are resource intensive, and research has shown that NHs with high percentages of low-income residents are especially challenged to adopt these initiatives.

This chapter takes a novel approach to examine factors that impact the adoption of culture-change initiatives by assessing knowledge management and the role of knowledge management activities in promoting the adoption of innovative care delivery models among under-resourced NHs throughout the United States. Using primary data from a survey of NH administrators, we conducted logistic regression models to assess the relationship between knowledge management and the adoption of a culture-change initiative as well as whether these relationships were moderated by leadership and staffing stability. Our study found that NHs were more likely to adopt a culture-change initiative when they had more robust knowledge management activities. Moreover, knowledge management activities were particularly effective at promoting adoption in NHs that struggle with leadership and nursing staff instability. Our findings support the notion that knowledge management activities can help NHs acquire and mobilize informational resources to support the adoption of care delivery innovations, thus highlighting opportunities to more effectively target efforts to stimulate the adoption and spread of these initiatives.

In today’s challenging world, achieving professional commitment among healthcare workers is becoming the need of time. Drawing on self-determination theory, the current study examines how and under which boundary conditions perceived organizational support affects professional commitment.

Data was collected from doctors and nurses employed in public and private sector hospitals by employing a split-questionnaire design.

The authors’ study findings demonstrate that perceived organizational support has a positive and indirect effect on the professional commitment of nurses and doctors via mediating the role of subjective well-being. The authors also found that these findings depend on healthcare workers’ burnout levels. The positive relationship between perceived organizational support and subjective well-being is attenuated by burnout syndrome.

The current study poses implications for policymakers and administrators of healthcare institutions as well as to develop a supportive culture to evoke more professional commitment among healthcare workers. Implications for nursing managers and policymakers are discussed in light of the study findings.

Healthcare institutions are increasingly paying attention to raising the professional commitment of their workforce, especially in the wake of a crisis like the COVID-19 outbreak. The current study will add to the body of literature on nursing management, healthcare studies and organizational psychology in the South Asian context by explaining the relationship between POS and professional commitment, drawing on self-determination theory.

This study aims to examine the level of intention to pursue formal nursing leadership roles among millennial nurses and to identify the different factors that may play a role in their intentions to pursue such roles.

This study used a multi-center, cross-sectional research design. Registered nurses born between 1980 and 2000 (n = 1,377) who worked in 23 acute care hospitals in Oman were included in this study. Data were analyzed using descriptive statistics and multiple linear regression. Data were collected between July 2019 and January 2020.

Nearly 70% of millennial nurses researched their intention for career advancement to assume nursing leadership responsibility. Factors associated with nurses’ intention to pursue formal nursing leadership roles were the type of nursing degree held (having a bachelor of science in nursing degree), type of hospital facility affiliation (teaching hospital), previous leadership experience, structural empowerment (access to support, opportunity and resources), work satisfaction and job burnout.

Millennial nurses, who represent the largest segment of the nursing workforce, have begun assuming nursing management and leadership roles; however, little is known about the factors affecting their intentions to pursue these roles. The findings of this study revealed different factors (both modifiable and nonmodifiable) influencing millennial nurses’ intentions to pursue formal leadership roles.

This study investigates the pathways for adopting IoTs and BDA technologies to improve healthcare management.

The study relied on 445 healthcare professionals' perspectives to explore different causal pathways to IoTs and BDA adoption and usage for daily healthcare management. The Fussy-set Qualitative Comparative Analysis was adopted to explore the underlying pathways for healthcare management.

The empirical analysis revealed six different configural paths influencing the acceptance and use of IoTs and BDA for healthcare improvement. Two key user topologies from the six configural paths, digital literacy and ease of use and social influence and behavioural intentions, mostly affect the paths for using digital health technologies by healthcare physicians.

Despite this study's novel contributions, limitations include the fsQCA methodology, perceptual data and the context of the study. The fsQCA methodology is still evolving with different interpretations, although it reveals new insights and as such further studies are required to explain the configural paths of social phenomena. Additionally, future research should consider other constructs beyond the UTAUT and digital literacy to illustrate configural paths to healthcare technology acceptance and usage. Again, the views of healthcare professionals are perceptual data. Hence future research on operational data will support significant contributions towards pathways to accept and use emerging technologies for healthcare improvement. Lastly, this study is from a developing country perspective where emerging digital healthcare technology is still emerging to support healthcare management. Hence, more investigation from other cross-country analyses of configural paths for digital technology deployment in healthcare will enhance the conversation with IoTs and BDA for healthcare management.

Holistically, the acceptance and use of healthcare technologies and platforms is not solely on their capabilities, but a combination of distinct factors driven by users' perspectives. This offers healthcare administrators and institutions to essentially reflect on the distinct combinations of conditions favourable to health professionals who can use IoTs and BDA for healthcare improvement.

This study is among the few scholarly works to empirically investigate the configural paths to support healthcare improvement with emerging technologies. Using fsQCA is a unique contribution to existing information system literature for configural paths for healthcare improvement with emerging digital technologies.

The purpose of this rapid review was to present current evidence on relations between resilience and self-efficacy among healthcare practitioners in the context of COVID-19 pandemic.

Literature searches were conducted in February/2022 in the online database MEDLINE EBSCO and not date/time limited. Eligibility criteria were as follows: population – healthcare practitioners, interest – relations between resilience and self-efficacy and context – COVID-19.

Six eligible studies from Italy, China, United Kingdom, India, Pakistan and Spain, published between 2020 and 2021 were included in the review. All studies used quantitative methods. The relations between resilience and self-efficacy were identified in contexts of resilience programs, measuring mental health of frontline nurses, measuring nurses' and nursing students' perception of psychological preparedness for pandemic management, perception of COVID-19 severity and mediating roles of self-efficacy and resilience between stress and both physical and mental quality of life. Findings indicated limited research on this topic and a need for more research.

Broader understanding of the relations between resilience and self-efficacy may help healthcare organizations' leaders/managers aiming to support resilience of their employers under challenging circumstances such as future pandemic.

The latest COVID-19 pandemic presented the opportunity to research relations between resilience and self-efficacy and enrich existed research in a new and extraordinary context.

The study aims to drive conceptual clarity around resistance to information technology projects, integrating multiple facets of the phenomenon from earlier studies.

The study conducts a meta-synthesis of qualitative studies on resistance to technology projects; it analyzes those studies at a case-specific level, compares and contrasts emergent concepts against each other, and “translates” those to the rest of the studies. The study uses the seven-step meta-ethnography method by Noblit and Hare to reciprocally translate emergent concepts to construct the conceptual model.

Through meta-synthesis, the study derives a new conceptual model for resistance to information technology projects, exemplifying how the identified antecedents create user resistance and how the phenomenon progresses within organizations.

This study enriches the observations and conclusions of past individual studies while explicating various facets of the mechanisms that generate and progress technology resistance within organizations. It offers fresh insights into the equivocal nature of the phenomenon and the distinctive ways it progresses from individual to group level.

Many ambitious and costly digital transformation efforts do not succeed due to user resistance. Understanding the mechanisms that create user resistance can help organizations manage technology projects better, thereby reducing the technology assimilation gap and protecting returns on related investments.

There have been extensive studies on technology acceptance (enablers) within organizations, while those relating to technology inhibitors are somewhat limited. However, the symmetry of understanding between enablers and inhibitors is vital for organizations to assimilate promising technologies and transform their business models. This model uses a new lens of sensemaking theory to explain how the antecedents trigger perceived threats and resistance behavior; it highlights the nuances around the development of resistance within individuals and its progression to groups. The resultant model offers better generalizability in organizational contexts.

This paper aims to report on research undertaken in an National Health Service (NHS) emergency department in the north of England, UK, to identify which patients, with which clinical conditions are returning to the emergency department with an unscheduled return visit (URV) within seven days. This paper analyses the data in relation to the newly introduced Integrated Care Boards (ICBs). The continued upward increase in demand for emergency care services requires a new type of “upstreamist”, health system leader from the emergency department, who can report on URV data to influence the development of integrated care services to reduce further demand on the emergency department.

Patients were identified through the emergency department symphony data base and included patients with at least one return visit to emergency department (ED) within seven days. A sample of 1,000 index visits between 1 January 2019–31 October 2019 was chosen by simple random sampling technique through Excel. Out of 1,000, only 761 entries had complete data in all variables. A statistical analysis was undertaken using Poisson regression using NCSS statistical software. A review of the literature on integrated health care and its relationship with health systems leadership was undertaken to conceptualise a new type of “upstreamist” system leadership to advance the integration of health care.

Out of all 83 variables regressed with statistical analysis, only 12 variables were statistically significant on multi-variable regression. The most statistically important factor were patients presenting with gynaecological disorders, whose relative rate ratio (RR) for early-URV was 43% holding the other variables constant. Eye problems were also statistically highly significant (RR = 41%) however, clinically both accounted for just 1% and 2% of the URV, respectively. The URV data combined with “upstreamist” system leadership from the ED is required as a critical mechanism to identify gaps and inform a rationale for integrated care models to lessen further demand on emergency services in the ED.

At a time of significant pressure for emergency departments, there needs to be a move towards more collaborative health system leadership with support from statistical analyses of the URV rate, which will continue to provide critical information to influence the development of integrated health and care services. This study identifies areas for further research, particularly for mixed methods studies to ascertain why patients with specific complaints return to the emergency department and if alternative pathways could be developed. The success of the Esther model in Sweden gives hope that patient-centred service development could create meaningful integrated health and care services.

This research was a large-scale quantitative study drawing upon data from one hospital in the UK to identify risk factors for URV. This quality metric can generate important data to inform the development of integrated health and care services. Further research is required to review URV data for the whole of the NHS and with the new Integrated Health and Care Boards, there is a new impetus to push for this metric to provide robust data to prioritise the need to develop integrated services where there are gaps.

To the best of the authors’ knowledge, this is the first large-scale study of its kind to generate whole hospital data on risk factors for URVs to the emergency department. The URV is an important global quality metric and will continue to generate important data on those patients with specific complaints who return back to the emergency department. This is a critical time for the NHS and at the same time an important opportunity to develop “Esther” patient-centred approaches in the design of integrated health and care services.

Using multiple theoretical lenses, the paper develops and empirically tests a service design-based framework of effective customer participation (CP) in service delivery. Particularly, the paper examines the impact of customer education on effective CP, besides the latter's effect on service quality. The direct and moderating effect of service modularity on the association between customer education and effective CP is also studied.

Covariance-based structural equation modeling is used to test the hypotheses using the survey data collected from the healthcare industry within Pakistan.

The results lend support for the presence of individual and mutually reinforcing effects of customer education and service modularity on effective CP in service delivery, ultimately affecting service quality.

Building on the CP and customer learning literature, this research extends the work on antecedents and consequences of effective CP in the larger domain of the service design and service delivery literature.

The findings reveal that service managers should design services such that by design, CP is ingrained within service delivery processes so that it is effectively managed during service delivery for superior service quality.

Given the already scant research that has either taken a narrower view of CP (mostly in pre- or post-service delivery), the current research makes one of the initial attempts to identify, theorize and empirically test the service design level antecedents for holistic CP spanning over the physical, behavioral and informational participation during the service delivery.

This paper aims to investigate the relationship between emotional labor and workplace violence based on the social exchange theory. Drawing on the social exchange theory, this paper aims to investigate the relationship between emotional labor and workplace violence. Specifically, the authors take a relational approach by introducing positive patient treatment as the mediator. The moderating role of organizational support in the relationship between emotional labor and workplace violence is also considered.

The data of this study encompasses 536 nurses from 10 university hospitals in Turkey. Hierarchical multiple regression analysis was conducted to test the proposed model.

The findings of this study support the negative effect of emotional labor on workplace violence and the mediating effect of patient-positive treatment. Moreover, when organizational support is low, the relationship between emotional labor and workplace violence is strong. In contrast, the effect is weak when organizational support is high.

The findings of this study suggest that health-care administrators should offer more training to nurses to help them manage their emotions while interacting with their patients. This leads to positive interpersonal relationships, which, in turn, lowers workplace violence. Moreover, health-care administrators should pay more attention to the buffering role of perceived organizational support for those subordinates with low emotional labor and higher workplace violence.

The study provides new insights into emotional labor’s influence on workplace violence and the moderating role of organizational support in the link between emotional labor and workplace violence. The paper also offers practical assistance to nurses in the health-care industry interested in building positive patient treatment and trust with their patients and minimizing workplace violence.

The purpose of this paper is to determine the relationship between trait and situational empathy, and the effect of educational activities on empathy of nursing students towards people living with dementia.

This embedded mixed-methods study compared trait and situational empathy examined situational empathy pre/post didactic and experiential activities with nursing students and used qualitative data from focus group discussions to corroborate the quantitative data.

There was no significant difference between trait and situational empathy. Post intervention scores (situational) demonstrated improvements on empathic concern, shared affect, empathic imagination, helping motivation and cognitive empathy. Focus group discussions supported quantitative findings and also included distress.

Limitations include lack of generalizability, single group threats and exclusion of stakeholder input. Single group threats include absence of a control group, familiarity with the CSES from pre-test to post-test and reactive measurements, as the students were observed by faculty while completing the Dementia Live activity. The perspective of stakeholders would strengthen the impact of the results on implementation.

Information gleaned from this study can help inform administrators in education and in practice. CliftonStrengths assessment and Dementia Live simulation activities can be used for administrators, faculty and students in schools of nursing as well as administrators and health-care workers.

Information from this study can impact those living with dementia as well as their caregivers.

Most studies involving health-care students and empathy do not delineate between trait and situational empathy. This study is unique in that it measured both and sought a relationship between the two. Determining one's personal attributes such as trait empathy, can help students capitalize on their strengths and ultimately enhance patient care.