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The primary objective of this study is to investigate the ethical implications of deploying AI-enabled chatbots in the healthcare sector. In addition, the research underscores trust and reliability as critical factors in addressing the ethical challenges associated with these chatbots.

This study takes a qualitative approach, conducting 13 semi-structured interviews with a diverse range of participants, including patients, healthcare professionals, academic researchers, ethicists, and legal experts. This broad spectrum of perspectives ensures a comprehensive understanding of the ethical implications of AI-enabled chatbots in healthcare. The rich exploratory data gathered from these interviews is then analysed using thematic analysis.

The findings of this study are highly significant in the context of AI-enabled healthcare chatbots. They highlight four major themes: developing trust, ensuring reliability, ethical considerations, and potential ethical implications. The interconnectedness of these themes forms a coherent narrative, highlighting the pivotal role of trust and reliability in mitigating ethical issues.

This study contributes to the existing literature on AI-enabled healthcare chatbots. It not only reveals potential ethical concerns associated with these technologies, such as data security, patient privacy, bias, and accountability, but it also places a significant emphasis on trust and reliability as critical elements that can boost user confidence and engagement in using AI-enabled chatbots for healthcare advice.

Previous research has demonstrated that social-relational factors are instrumental to employee voice. An essential aspect of this relates to notions of respect or disrespect. Although nurses commonly report experiencing professional disrespect in their interaction with doctors, earlier studies have focused on how the professional status hierarchy and power imbalance between doctors and nurses hinder speaking up without considering the role of professional disrespect. Addressing this gap, we explore how professional disrespect in the doctor–nurse relationship in surgical teams influences the willingness of nurses to voice legitimate concerns about threats to patient safety.

Fifty-seven semi-structured interviews with nurses drawn from a range of specialities, ranks and surgical teams in three hospitals in a West African Country. In addition, two interviews with senior representatives from the National Registered Nurses and Midwifery Association (NRNMA) of the country were undertaken and analysed thematically with the aid of NVivo.

Disrespect is expressed in doctors’ condescending attitude towards nurses and under-valuing their contribution to care. This leads to safety concerns raised by nurses being ignored, downplayed or dismissed, with deleterious consequences for patient safety. Feeling disrespected further motivates nurses to consciously disguise silence amidst speech and engage in punitive silence aimed at making clinical practice difficult for doctors.

We draw attention to the detrimental effect of professional disrespect on patient safety in surgical environments. We contribute to employee voice and silence by showing how professional disrespect affects voice independently of hierarchy and conceptualise the notion of punitive silence.

With the soaring rise in popularity of social media platforms in recent decades, the use of website posts for the expression of work-related views has also increased. Despite websites being extensively used, there has been no examination of the views and concerns expressed by frontline workers through website posts. The present research aims to contribute to the “voice literature” first by evaluating how frontline workers utilize anonymous media platforms to express their views and work-related concerns and, second, by demonstrating how anonymous voice systems can encourage frontline health workers in providing feedback and dissatisfaction.

The study utilizes the thematic analysis method to analyze the content of posts by psychologists on a collaborative consultation website administrated by Israel’s Ministry of Health, discussing their perceptions of work-related concerns.

The analysis identified three work-related themes through the employees' voices. These include insufficient support from management, conflicts and excessive occupational demands. The workers expressed their apprehension with regard to organizational pressures, deficient budget allocations, excessive workloads, lack of recognition and work–life imbalances.

The application of thematic analysis method to anonymous open-public data should be viewed as an effective, affordable, genuine and unique research method for data analysis. Anonymous platforms can generate unique insights that may not be possible through traditional means. This can provide practitioners with a comprehensive understanding of various issues and challenges and be a useful tool for identifying shortcomings within health settings.

Service organizations operate in an increasingly complex and uncertain context that makes decision-making challenging. Despite well-recognized changes in the operational context of government as service organization, service literature has given surprisingly limited attention to what these changes imply for organizational decision-making. This study aims to face with the lack of fit of decision-making theorizing with the reality, within which most service practitioners operate, in order to foster the relevance of decision-making in service research and properly approach the false assumptions and misguided instructions for action.

To rectify the situation, the purpose of this paper is to advance a more holistic understanding of decision-making in government as service organization. The authors do so by reviewing the sparse, though insightful, prior literature on decision-making in service research and identifying four foundational assumptions of decision-making in the service context, that radically differ from the traditional assumptions of decision-making within the wider management literature.

The authors contribute to service research by further advancing the emerging dynamic understanding of decision-making by developing eight systems thinking-informed research propositions and a connected research agenda. In doing so, the paper offers the essential ground work that can revitalize the field of service management and equip it for facing the challenges that government as service organization is encountering in the 21st century.

The formulated eight research propositions demonstrate that decision-making in a government as service organization occurs within complex adaptive systems composed of multiple subsystems and is characterized by a high degree of unpredictability. It is a process influenced by multiple actors part of the system and subsystems, through multiple feedback loops, where the implications of prior decisions inform the future decisions.

The purpose of this study is to comprehensively explore the impact of digitalization on healthcare supply chains (HcSCs). It seeks to understand how digital technologies enhance efficiency, transparency and responsiveness within these complex logistical systems. The study aims to provide a holistic view of the transformative potential of digitalization in the healthcare sector, with a particular focus on improving patient care and streamlining operational processes.

This research employs a systematic review methodology, carefully curating a selection of 45 relevant articles from 66 articles rigorously screened using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology to provide a holistic view. It follows established systematic review protocols, incorporating a meticulous search strategy and precise keyword selection. The chosen research design enables a comprehensive examination of the existing body of knowledge concerning digital platforms, real-time tracking technologies, transparency and responsiveness in the context of HcSCs.

The findings of this study emphasize the pivotal role of digital technologies in reshaping HcSCs. Digital platforms, real-time tracking systems and technological integrations substantially enhance efficiency, transparency and responsiveness. Data-driven decision-making, improved communication and agile responses to dynamic demands are key aspects. These findings underscore the transformative impact of digitalization on healthcare logistics, emphasizing the potential for streamlined operations, enhanced patient care and more efficient resource allocation.

Despite the systematic methodology, this study is subject to certain limitations. It relies on existing literature, which may not cover the most recent developments in the rapidly evolving field of digital HcSCs. Furthermore, the study may be influenced by publication bias. The implications suggest the need for continued research to explore emerging digital technologies and their effects on healthcare logistics, ensuring that supply chains remain agile and responsive.

The practical implications of this research are significant for HcSC managers with insights into digital technologies to enhance transparency and collaboration and improve resource visibility. The integration of data analytics can lead to more effective inventory management and demand forecasting. Blockchain (BC) technology can ensure transparent and secure transactions, fostering trust among stakeholders. For practitioners, this research offers actionable guidance for navigating the digital age, promoting operational efficiency and ensuring a consistent supply of essential medical products. Researchers can use these insights as a foundation for further exploration into the potential of digitalization in HcSCs.

The social implications of digitalization in HcSCs are far-reaching. They encompass improved patient care, as digital technologies enhance the efficiency, transparency and responsiveness of supply chains. This translates to better access to critical medical supplies, potentially reducing healthcare disparities and benefiting underserved populations. Enhanced patient safety is a significant social outcome, as transparent and secure transactions enabled by technologies like BC mitigate the risks associated with counterfeit medications. Furthermore, digitalization builds trust among stakeholders, promotes accountability and fosters resilient healthcare systems, which are capable of responding effectively to crises. It also has the potential to make healthcare more affordable, contributing to increased healthcare access and transparency in decision-making.

The originality and value of this study lie in its comprehensive synthesis of diverse findings related to digitalization in HcSCs. While prior studies have examined isolated facets of digital technology adoption, this research provides a comprehensive overview. It contributes to a deeper understanding of the transformative potential of digitalization within the healthcare sector, offering practical approaches to enhance patient care and streamline operations.

This study aims to investigate the conceptual relationship between full-range leadership theory (FRLT) and patient safety culture in primary care settings, aiming to understand how leadership styles influence the development and sustainability of a culture prioritizing patient safety.

Using a conceptual analysis approach, the study builds a theoretical framework that integrates FRLT – which includes transformational, transactional and laissez-faire leadership styles – with the elements of patient safety culture. This framework serves as the basis for a comprehensive literature review, allowing for the formulation of hypotheses regarding the impact of each leadership style on patient safety culture.

The analysis demonstrates that transformational leadership bolsters patient safety culture by fostering open communication, encouraging error reporting and facilitating continuous improvement. Transactional leadership yields mixed effects, effectively supporting compliance and operational outcomes but showing limitations in promoting a proactive safety culture. Conversely, laissez-faire leadership is associated with negative outcomes for patient safety culture, mainly due to its passive and detached approach.

The originality of this study is rooted in its focused examination of FRLT’s impact on patient safety culture within primary care settings, the development of a unique conceptual framework and its contribution of actionable insights for health-care leadership. These elements collectively advance the understanding of how leadership can enhance patient safety culture, providing a solid foundation for future research and practical application in primary care environments.

Further investigation is needed of network effectiveness in healthcare and how it is influenced by unpredictable events like COVID-19. Based on Provan and Milward’s (2001) framework, this study investigates the effectiveness criteria of healthcare networks and their potential contribution to network effectiveness during the pandemic’s challenges.

This research employs an explanatory case study in a local area of Italy’s Lombardy Region and analyzes network effectiveness at the network level based on network member perceptions.

Network effectiveness refers to the network’s ability to address patient needs, guaranteeing services through network members' coordinated efforts and a central coordinator that facilitates their interaction. Members’ capacity to strengthen their roles played a crucial part in sustaining network effectiveness when COVID-19 revised other members’ priorities and threatened achievement of network goals.

This study’s findings equip healthcare managers and policymakers with knowledge about network effectiveness criteria at the network level, offering suggestions for managerial practices and network design to address exogenous shocks.

This study identifies factors that influence network effectiveness criteria and provides insight into how network members can contribute to sustaining effectiveness during crises.

General Data Protection Regulation (GDPR) of the European Union (EU) was passed to protect data privacy. Though the GDPR intended to address issues related to data privacy in the EU, it created an extra-territorial effect through Articles 3, 45 and 46. Extra-territorial effect refers to the application or the effect of local laws and regulations in another country. Lawmakers around the globe passed or intensified their efforts to pass laws to have personal data privacy covered so that they meet the adequacy requirement under Articles 45–46 of GDPR while providing comprehensive legislation locally. This study aims to analyze the Malaysian and Saudi Arabian legislation on health data privacy and their adequacy in meeting GDPR data privacy protection requirements.

The research used a systematic literature review, legal content analysis and comparative analysis to critically analyze the health data protection in Malaysia and Saudi Arabia in comparison with GDPR and to see the adequacy of health data protection that could meet the requirement of EU data transfer requirement.

The finding suggested that the private sector is better regulated in Malaysia than the public sector. Saudi Arabia has some general laws to cover health data privacy in both public and private sector organizations until the newly passed data protection law is implemented in 2024. The finding also suggested that the Personal Data Protection Act 2010 of Malaysia and the Personal Data Protection Law 2022 of Saudi Arabia could be considered “adequate” under GDPR.

The research would be able to identify the key principles that could identify the adequacy of the laws about health data in Malaysia and Saudi Arabia as there is a dearth of literature in this area. This will help to propose suggestions to improve the laws concerning health data protection so that various stakeholders can benefit from it.

This paper examines the efforts of National Health Service (England) (NHSE) to respond to employee-based racial inequalities via its Workforce Race Equality Standard (WRES). The WRES constitutes a hybridised accountability initiative with characteristics of the moral and imposed regimes of accountability.

The study conceptualises the notion of responsive race accountability with recourse to Favotto et al.’s (2022) moral accountability model and critical race theory (CRT), and through it, examines the enactment of WRES at 40 NHSE trusts using qualitative content analysis.

Despite the progressive nature of the WRES that seeks to nurture corrective actions, results suggest that trusts tend to adopt an instrumental approach to the exercise. Whilst there is some evidence of good practice, the instrumental approach prevails across both the metric reporting that trusts engage in to guide their actions, and the planned actions for progress. These planned actions not only often fail to coalesce with the trust-specific data but also include generic NHSE or equality, diversity and inclusion initiatives and mimetic adoptions of best practice guidance that only superficially address racial concerns.

Whilst the WRES is a laudable voluntary achievement, its moral imperative does not appear to have translated into a moral accountability within individual trusts.

Responding to calls for more research at the accounting-race nexus, this study uniquely draws on CRT to conceptualise and examine race accountability.

This study demonstrates how becoming a high-reliability institution in health care is a priority, given the high-risk environment in which an error can result in harm. Literature conceptually supports the need for highly reliable health care facilities but does not show a comprehensive approach to operationalizing the concept into the daily workforce to support patients. The Veterans Health Administration closes the gap by documenting a case study that not only demonstrates specific actions and functions that create a high-reliability organization (HRO) for safety and improvement but also created a learning organization by spreading the knowledge to other facilities.

The authors instituted a methodology consisting of assessments, training and educational simulations to measure, establish and operationalize activities that identified and prevented harmful events. Visual communication boards were created to facilitate team huddles and discuss improvement ideas. Improvements were then measured and analyzed for purposeful outcomes and return on investment (ROI).

HRO can be operationalized successfully in health care systems. Measurable outcomes verified that psychological safety was achieved through the identification and participation of 3,184 process improvement projects over a five-year period, which yielded a US$2.8m ROI. Documented processes and activities were used for educational teachings, which were disseminated to other Veteran Affairs Medical Center’s through the Truman HRO Academy.

This case study is limited to one hospital in the Veterans Health Administration (VHA) network. As the VHA continues to deploy the methods outlined to other hospitals, the authors will perform incremental data collection and ongoing analysis for further validation of the HRO methods and operations. Hospitalists can adapt the methods in the case study for practical application in a health care setting outside of VHA. Although the model is rooted in health care, the methods may be adapted for use in other industries.

This case study overcomes the limitations within literature regarding operationalizing HRO by providing actual activities and demonstrations that can be implemented by other health care facilities.