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Workplace voice is well-established and encompasses behaviors such as prosocial voice, informal complaints, grievance filing, and whistleblowing, and it focuses on interactions between the employee and supervisor or the employee and the organizational collective. In contrast, our chapter focuses on employee prosocial advocacy voice (PAV), which the authors define as prosocial voice behaviors aimed at preventing harm or promoting constructive changes by advocating on behalf of others. In the context of a healthcare organization, low quality and unsafe patient care are salient and objectionable states in which voice can motivate actions on behalf of the patient to improve information exchanges, governance, and outreach activities for safer outcomes. The authors draw from the theory and research on responsibility to intersect with theories on information processing, accountability, and stakeholders that operate through voice between the employee-patient, employee-coworker, and employee-profession, respectively, to propose a model of PAV in patient-centered healthcare. The authors complete the model by suggesting intervening influences and barriers to PAV that may affect patient-centered outcomes.

This mixed methods multiple case study examines the knowledge, understanding, and awareness of 25 health board/facility oversight managers and 20 health professional association directors about privacy and security issues important to achieving health information exchange (HIE) in the state of Nebraska. Within case analyses revealed that health board/facility oversight managers were unaware of key elements of the federal agenda; their concerns about privacy encompassed broad definitions both of what constituted a “health record” and “regulations centeredness.” Alternatively, health professional association leaders were keenly aware of national initiatives. Despite concerns about HIE, they supported information exchange believing that patient care quality and safety would improve. Cross-case analyses revealed a perceptual disconnect between board/facility oversight managers and professional association leaders; however, both favored HIE. Understanding state-level stakeholder perceptions helps us further understand our progress toward achieving the national health information interoperability goal. There is an ongoing need to assure adequate patient privacy protection. Licensure and facility boards at the state level are likely to have a major role in the assurance of patient protections through facility oversight and provider behavior. The need for these boards to take an active role in oversight of patient rights and protections is imminent. Similarly, professional associations are the major vehicles for post-graduate education of practicing health professionals. Their engagement is essential to maintaining health professions knowledge. States will need to understand and engage both of these key stakeholders to make substantial progress in moving the HIE agenda forward.

Purpose – This paper focuses on efficiency as a central theme of the Italian health care reforms, combining macrolevel policies with microlevel (i.e., operating room) perceptions of the concept.

Design/Methodology/Approach – According to the phenomenographic approach, this analysis investigates how the components of a surgical team (22 semistructured interviews) experience efficiency in their daily workflows.

Findings – The main findings show that the concept of efficiency is multidimensional. According to participants’ perspective, several categories of efficiency collected in an outcome space emphasize an holistic view of efficiency driving health policies and strategies.

Social implications – The suggestion of further relationships between perspectives and other constructs (i.e., quality, safety, patient focus, process) at micro and macro level could enhance the impact of health reforms.

Originality/Value – A qualitative approach conducted at microlevel help to recognize the phenomenon (of efficiency), engaging the individual conception that practitioners have of the health efficiency.

The twentieth century started writing the history of modern health systems. Their evolvable rate is now higher than ever. The Western Europe was the forefront of setting up the national health systems (NHS) to protect citizens and let them thrive. Successful models progressively crossed the borders and experiences became universal. Hence, this chapter tackles data to perceive the underwent radical transformations and capture intricate aspects to envision the next and get answers time ahead the patients‘needs. Health organizational structures and human resources management play crucially in improving system’s performances: managerial qualities, medical entities’ functionality, results’ forecasting are essential to build up credibility and aid strategic patterns to evolve.

Changes are welcome to better tailor performances, assure successful implementation, avoid inadequate, distressing reforms. Stable and consistent policies are also called for.

Grounded on fundamental patterns, open to applicatory innovation, countries follow specific arrangements to resound with healthcare robustness if goals are well-thought-of: keeping people healthy and safe, identifying and treating defectiveness or abnormal physiological functions affecting people, operations, circuits, and preserving health budget wisely balanced.

Activities and citizens are touched by any structural changes maneuvered. To confront them, a keen eye should be addressed to those nobody’s areas into synergistic efforts to cope with internal causes, face external forces and improve life through fair profitability on the way of full satisfaction.

The issues of women empowerment and gender equality have gained the increased attention of scholars and policymakers in Western societies. Gender diversity and the professional participation of women are increasingly acknowledged as transversal drivers for economic development. However, in less developed countries, research and evidence are still accumulating. Thus, this study aims to explore actors and factors empowering female talent to work and achieve managerial positions and run their businesses in two countries with patriarchal social and cultural norms, Saudi Arabia and Kazakhstan. Based on the qualitative interview data collected from 15 female managers and entrepreneurs working in the healthcare sector, we explore the conditions under which women can start their businesses and get promoted to managerial positions in the organizations. Our findings indicate that individual agencies and structural factors in female talent capacity building and empowering women to achieve higher hierarchical positions in organizations form together important dynamics that foster more inclusive practices and internalized schemes. Furthermore, the findings also demonstrate the importance of female talent empowerment in achieving gender diversity in managerial positions in healthcare organizations. Hence, by stating that increased female talent participation in the upper-echelons of the organization and entrepreneurship contributes to the decent employment of women in countries with male-dominated social and cultural norms and promotes the more inclusive and sustainable economic growth of these countries, our research contributes to United Nations (UN) Sustainable Development Goals (SDG) #5.5, #8.5 and #10.2.

The constitution of the United States refers to the obligation of the government to safeguard the people's health and welfare. For those engaged in patient care, the health and safety of the patient is uppermost, but the safety of the patient is influenced by a multitude of factors. These factors include not only the actions of the providers of care and the patient's environment, but also the patient's own actions.

Although adverse events are less studied in the prehospital setting, the evidence is beginning to paint an alarming picture. Consequently, improvements in Emergency Medical Services (EMS) demand a paradigm shift regarding the way care is conceptualized. The chapter aims to (1) support the dialogue on near-misses and adverse events as a learning opportunity and (2) to provide insights on applications of multiteam systems (MTSs).

To offer discussion on near-misses and adverse events and knowledge on how MTSs are applicable to emergency medical care, we review and dissect a complex patient case.

Throughout this case discussion, we uncover seven pertinent issues specific to this particular MTS: (1) misunderstanding with number of patients and their locations, (2a) lack of context to build a mental model, (2b) no time or resources to think, (3) expertise-facilitated diagnosis, (4) lack of communication contributing to a medication error, (5) treatment plan selection, (6) extended time on scene, and (7) organizational culture impacting treatment plan decisions.

By dissecting a patient case within the prehospital setting, we can highlight the value in engaging in dialogue regarding near-misses and adverse events. Further, we can demonstrate the need to expand the focus from simply teams to MTSs.

Patient handoffs involve the exchange of information between health professionals accompanying a transfer of responsibility for, or control of, a patient. Concerns over the safety risks of poor handoffs have resulted in regulatory pressure to standardize practice and considerable growth in research. But handoffs involve more than information transfer, and their consequences for health care organizations extend beyond the safety of patients. Using an organization theory lens, we review the literature on handoffs and propose a framework that characterizes handoffs as multifunctional, situated organizational routines. We also identify implications for researchers and hospital policymakers. Standardization and improvement efforts run the risk of causing unintended problems if they overlook the complexity of handoff and the larger organizational functions it serves. Deepening our understanding of the multifunctional, situated nature of handoff can lead to improvement efforts that not only safeguard individual patients, but also enhance the capabilities of the larger health care organization.

This chapter proposes an optimized innovative information technology as a means for achieving operational functionalities of real-time portable electronic health records, system interoperability, longitudinal health-risks research cohort and surveillance of adverse events infrastructure, and clinical, genome regions – disease and interventional prevention infrastructure. In application to the Dod-VA (Department of Defense and Veteran's Administration) health information systems, the proposed modernization can be carried out as an “add-on” expansion (estimated at $288 million in constant dollars) or as a “stand-alone” innovative information technology system (estimated at $489.7 million), and either solution will prototype an infrastructure for nation-wide health information systems interoperability, portable real-time electronic health records (EHRs), adverse events surveillance, and interventional prevention based on targeted single nucleotide polymorphisms (SNPs) discovery.