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Value-based healthcare suggested using patient-reported information to complement the information available in the medical records and administrative healthcare data to provide insights into patients' perceptions of satisfaction, experience and self-reported outcomes. However, little attention has been devoted to questions about factors fostering the use of patient-reported information to create value at the system level.

Action research design is carried out to elicit possible triggers using the case of patient-reported experience and outcome data for breast cancer women along their clinical pathway in the clinical breast network of Tuscany (Italy).

The case shows that communication and engagement of multi-stakeholder representation are needed for making information actionable in a multi-level, multispecialty care pathway organized in a clinical network; moreover, political and managerial support from higher level governance is a stimulus for legitimizing the use for quality improvement. At the organizational level, an external facilitator disclosing and discussing real-world uses of collected data is a trigger to link measures to action. Also, clinical champion(s) and clear goals are key success factors. Nonetheless, resource munificent and dedicated information support tools together with education and learning routines are enabling factors.

Current literature focuses on key factors that impact performance information use often considering unidimensional performance and internal sources of information. The use of patient/user-reported information is not yet well-studied especially in supporting quality improvement in multi-stakeholder governance. The work appears relevant for the implications it carries, especially for policymakers and public sector managers when confronting the gap in patient-reported measures for quality improvement.

This study aimed to examine the financial risk-taking behaviors of adult individuals diagnosed with attention deficit hyperactivity disorder (ADHD).

The study was conducted with adults (n = 80) diagnosed with ADHD and healthy controls (n = 80). In order to measure risk-taking in the financial domain, the items in the investment and gambling sub-dimensions of the Domain-Specific Risk-Taking Scale (DOSPERT) were applied.

Adults with ADHD had higher investment and gambling risk-taking and expected benefits scores than the control group, and there was no difference between the two groups in terms of risk perceptions. In the regression analysis, there was a positive linear relationship between the investment and gambling risk-taking scores and the expected benefits scores in both groups. There was a negative linear relationship between investment risk-taking and risk perceptions scores only in the control group.

In terms of investment and gambling, both risk-taking and expected benefits are greater in individuals with ADHD. It has been observed that while healthy individuals take investment risks, they evaluate according to the expected benefits and risk perceptions, while individuals with ADHD make evaluations only according to the expected benefits, risk perceptions do not predict financial risk-taking in individuals with ADHD. When it comes to risk-taking related to gambling, both groups take risks only according to their expectations of benefits, not their perceptions of risk. The study provides outputs that can contribute to the literature in terms of the effects of ADHD diagnosis on financial decision-making processes in the context of risk-taking.

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 survey explores the application of real options theory to the field of health economics. The integration of options theory offers a valuable framework to address these challenges, providing insights into healthcare investments, policy analysis and patient care pathways.

This research employs the real options theory, a financial concept, to delve into health economics challenges. Through a systematic approach, three distinct models rooted in this theory are crafted and analyzed. Firstly, the study examines the value of investing in emerging health technology, factoring in future advantages, associated costs and unpredictability. The second model is patient-centric, evaluating the choice between immediate treatment switch and waiting for more clarity, while also weighing the associated risks. Lastly, the research assesses pandemic-related government policies, emphasizing the importance of delaying decisions in the face of uncertainties, thereby promoting data-driven policymaking.

Three different real options models are presented in this study to illustrate their applicability and value in aiding decision-makers. (1) The first evaluates investments in new technology, analyzing future benefits, discount rates and benefit volatility to determine investment value. (2) In the second model, a patient has the option of switching treatments now or waiting for more information before optimally switching treatments. However, waiting has its risks, such as disease progression. By modeling the potential benefits and risks of both options, and factoring in the time value, this model aids doctors and patients in making informed decisions based on a quantified assessment of potential outcomes. (3) The third model concerns pandemic policy: governments can end or prolong lockdowns. While awaiting more data on the virus might lead to economic and societal strain, the model emphasizes the economic value of deferring decisions under uncertainty.

This research provides a quantified perspective on various decisions in healthcare, from investments in new technology to treatment choices for patients to government decisions regarding pandemics. By applying real options theory, stakeholders can make more evidence-driven decisions.

Decisions about patient care pathways and pandemic policies have direct societal implications. For instance, choices regarding the prolongation or ending of lockdowns can lead to economic and societal strain.

The originality of this study lies in its application of real options theory, a concept from finance, to the realm of health economics, offering novel insights and analytical tools for decision-makers in the healthcare sector.

During the 1990s, Italian healthcare organisations (HOs) underwent a process of corporatisation, and the most innovative HOs introduced the balanced scorecard (BSC) to address the need for broader accountability. Currently, there is a limited understanding of the dynamics and outcomes of such a process. Therefore, this study aims to explore whether the BSC is still considered an effective performance management tool and analyse the factors driving and hindering its evolution and endurance in public and non-profit HOs.

We conducted a retrospective longitudinal analysis of two pioneering cases in the adoption of the BSC: one in a public hospital and the other in a non-profit hospital. Data collection relied on accessing institutional documents and reports from the early 2000s to the present, as well as conducting semi-structured interviews with the internal sponsors of the BSC.

We found evidence of three main categories of factors that trigger or hinder the adoption and development of the BSC: (1) the role of the internal sponsor and professionals’ commitment; (2) information technology and the controller’s technological skills; and (3) the relationship between the management and professionalism logics during the implementation process. At the same time, there is no evidence to suggest that specific technical features of the BSC influence its endurance.

The paper contributes to the debate on the key factors for implementing and sustaining multidimensional control systems in professional organisations. It emphasises the importance of knowledge-based assets and distinctive internal capabilities for the success of the business. The implications of the BSC legacy are discussed, along with future developments of multidimensional control tools aimed at supporting strategy execution.

The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.

The methodology entails the integration of service design (SD) and action research (AR) methodologies, characterized by iterative phases that systematically alternate between action and reflective processes, fostering cycles of change and learning. Within this framework, stakeholders are engaged through semi-structured interviews, while the existing and envisioned processes are delineated and represented using BPMN 2.0. These methodological steps emphasize the development of an autonomous, patient-centric web application alongside the implementation of an adaptable and patient-oriented scheduling system. Also, business processes simulation is employed to measure key performance indicators of processes and test for potential improvements. This method is implemented in the context of the CP addressing transient loss of consciousness (TLOC), within a publicly funded hospital setting.

The methodology integrating SD and AR enables the detection of pivotal bottlenecks within diagnostic CPs and proposes optimal corrective measures to ensure uninterrupted patient care, all the while advancing the digitalization of diagnostic CP management. This study contributes to theoretical discussions by emphasizing the criticality of process optimization, the transformative potential of digitalization in healthcare and the paramount importance of user-centric design principles, and offers valuable insights into healthcare management implications.

The study’s relevance lies in its ability to enhance healthcare practices without necessitating disruptive and resource-intensive process overhauls. This pragmatic approach aligns with the imperative for healthcare organizations to improve their operations efficiently and cost-effectively, making the study’s findings relevant.

The various quality improvement (QI) frameworks and maturity models described in the health services literature consider some aspects of QI while excluding others. This paper aims to present a concerted attempt to create a quality improvement maturity model (QIMM) derived from holistic principles underlying the successful implementation of system-wide QI programmes.

A hybrid methodology involving a systematic review (Phase 1) of over 270 empirical research articles and books developed the basis for the proposed QIMM. It was followed by expert interviews to refine the core constructs and ground the proposed QIMM in contemporary QI practice (Phase 2). The experts included academics in two academic conferences and 59 QI managers from the New Zealand health-care system. In-depth interviews were conducted with QI managers to ascertain their views on the QIMM and its applicability in their respective health organisations (HOs).

The QIMM consists of four dimensions of organisational maturity, namely, strategic, process, supply chain and philosophical maturity. These dimensions progress through six stages, namely, identification, ad-hoc, formal, process-driven, optimised enterprise and finally a way of life. The application of the QIMM by the QI managers revealed that the scope of QI and the breadth of the principles adopted by the QI managers and their HOs in New Zealand is limited.

The importance of QI in health systems cannot be overstated. The proposed QIMM can help HOs diagnose their current state and provide a guide to action achieving a desirable state of quality improvement maturity. This QIMM avoids reliance on any single QI methodology. HOs – using the QIMM – should retain full control over the process of selecting any QI methodology or may even cherry-pick principles to suit their needs as long as they understand and appreciate the true nature and scope of quality overstated. The proposed QIMM can help HOs diagnose their current state and provide a guide to action achieving a desirable state of quality improvement maturity. This QIMM avoids reliance on any single QI methodology. HOs – using the QIMM – should retain full control over the process of selecting any QI methodology or may even cherry-pick principles to suit their needs as long as they understand and appreciate the true nature and scope of quality.

This paper contributes new knowledge by presenting a maturity model with an integrated set of quality principles for HOs and their extended supply networks.

This study explored how organizational leaders at different hierarchical levels may communicatively enhance employees' health and well-being. Drawing on interdisciplinary research, it proposed a model that connects health-oriented leadership communication at supervisory and executive levels with remote workers' self-care and stress levels during the COVID-19 pandemic.

Data collected through a survey of 363 full-time United States (US) employees were analyzed to test the model.

Results showed health-oriented communication at the two leadership levels directly influenced employees' self-care, which in turn reduced their stress levels. Further, executive leaders' health-oriented leadership communication indirectly impacted remote workers' self-care through its positive association with supervisors' health-oriented leadership communication.

This study offers much-needed guidelines for executive leaders, supervisors and communication practitioners seeking to meet employees' growing expectations for a healthy work environment in today's post-pandemic era.

Although the literature has established organizational leadership as a vital determinant for a healthy workforce, few studies have explored leaders' health-specific communication to enhance employee health. This study is the first to conceptualize health-oriented leadership communication at dual hierarchical levels and uncover its influence on employees. The results suggested the importance of health-oriented leadership communication across hierarchical levels in building a healthy workplace.

In response to growing concerns over the negative consequences of Internet addiction on adolescents’ mental health, coupled with conflicting results in this literature stream, this meta-analysis sought to (1) examine the association between Internet addiction and depressive symptoms in adolescents, (2) examine the moderating role of Internet freedom across countries, and (3) examine the mediating role of excessive daytime sleepiness.

In total, 52 studies were analyzed using robust variance estimation and meta-analytic structural equation modeling.

There was a significant and moderate association between Internet addiction and depressive symptoms. Furthermore, Internet freedom did not explain heterogeneity in this literature stream before and after controlling for study quality and the percentage of female participants. In support of the displacement hypothesis, this study found that Internet addiction contributes to depressive symptoms through excessive daytime sleepiness (proportion mediated = 17.48%). As the evidence suggests, excessive daytime sleepiness displaces a host of activities beneficial for maintaining mental health. The results were subjected to a battery of robustness checks and the conclusions remain unchanged.

The results underscore the negative consequences of Internet addiction in adolescents. Addressing this issue would involve interventions that promote sleep hygiene and greater offline engagement with peers to alleviate depressive symptoms.

This study utilizes robust meta-analytic techniques to provide the most comprehensive examination of the association between Internet addiction and depressive symptoms in adolescents. The implications intersect with the shared interests of social scientists, health practitioners, and policy makers.

The purpose of this study is to introduce the concept of workplace camaraderie and to investigate the mechanism through which workplace camaraderie influences incivility at the workplace. The study is explained by taking the sequential mediation of personal biases leading to cronyism and favoritism. Social identity theory is used as the underpinning theory to explain the framework adopted.

Positivism research philosophy followed by the deductive approach is followed to meet the objectives of the current study. In total, 171 employees working in public sector organizations were taken as the respondents to the study. A purposive sampling technique was used to collect the data through self-administrated questionnaires. Path model is used through Mplus to generate the results and test hypotheses.

The results suggested that workplace camaraderie significantly affects incivility at a workplace with the sequential mediation of personal biases leading to cronyism and favoritism.

Although several researchers have studied the link between camaraderie and other employees’ related attitudinal and behavioral outcomes, few have explored the roles of personal biases, cronyism and favoritism in the relationship to incivility. This study thus posits a novel sequential mediation mechanism, based on the social identity theory, through which camaraderie is translated into civil behavior. Moreover, this study adds value by investigating this model in the public sector, where camaraderie can come up with important consequences.