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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.

Understanding the outcomes of co-creation (CC) in healthcare is increasingly gaining multidisciplinary scientific interest. Although more and more service management scholars have pointed out the benefits of cross-fertilization between the various research fields, the literature on this topic is still scattered and poorly integrated. This study aims to summarize and integrate multiple strands of extant knowledge CC by identifying the outcomes of health CC and the determinants of these outcomes and their relationships.

A structured literature review was conducted per PRISMA guidelines. A total of 4,189 records were retrieved from the six databases; 1,983 articles were screened, with 161 included in the qualitative thematic analysis.

This study advances a comprehensive framework for healthcare CC based on a thorough analysis of the outcomes and their determinants, that is, antecedents, management activities and institutional context. Extant research rarely evaluates outcomes from a multidimensional and systemic perspective. Less attention has been paid to the relationship among the CC process elements.

This study offers an agenda to guide future studies on healthcare CC. Highlighting some areas of integration among different disciplines further advances service literature.

The framework offers an operational guide to better shape managerial endeavors to facilitate CC, provide direction and assess multiple outcomes.

This is the first extensive attempt to synthesize and integrate multidisciplinary knowledge on CC outcomes in healthcare settings by adopting a systematic perspective on the overall process.

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.

It is over 20 years since the publication of the Wanless Report, “Securing our Future Health: Taking a Long-Term View”. The Wanless Report argued that the National Health Service (NHS) would survive in its current form only if the population became “fully engaged” with it.

In this discussion paper, the authors explored what “fully engaged” meant to Wanless, what it might mean now (allowing for the impact of the anti-vaxxer movement) and what policymakers could do to enhance public engagement.

Although the Wanless Report neatly fitted into other long-term thinking about the NHS, it was unique in that it built economic models to predict the costs and impact of different patterns of NHS performance. Wanless predicted that people’s poor levels of health would put considerable pressure on the NHS. This pressure could swamp efforts to meet healthcare targets and improve health outcomes, despite its sizeable investment of money. Wanless set out three possible scenarios for public engagement with the NHS: solid progress, slow uptake and fully engaged.

The authors pose questions for policymakers and practitioners. Would a reboot of the Wanless approach be worth the effort for policymakers? If yes, how would it differ from the original? The NHS faces the whole of society; could it be the vehicle for engaging the anti-vaxxer public with the truthfulness of medical science, and will it be this, that is, Wanless' enduring legacy?

The exploration of the Wanless Report is complicated (at least for the time being) by the rise of the anti-vaxxer movement’s resistance to health promotion and mistrust of part of the NHS.

Blockchain technology enhances information management in healthcare supply chains by securing healthcare information and providing medical resource traceability. However, there is no decision framework to support blockchain implementation for managing information, especially in emerging economies’ healthcare supply chains. This paper develops a hierarchical decision model for implementing blockchain technology for information management in emerging economies’ healthcare supply chains.

This study uses 20 health supply chain experts in Ghana to rank 17 decision criteria for implementing blockchain for healthcare information management using the best-worst method (BWM) multi-criteria decision technique.

The results show that “security” and “privacy,” “infrastructural facility” and “presence of training facilities” are the top three critical factors impacting blockchain adoption in the health supply chain for healthcare information management. Other sub-factors are prioritized.

To implement blockchain effectively to enhance information management in the healthcare supply chain, health institutions, blockchain technology providers and state authorities should concentrate on the highly critical factors extracted from the study.

This is the first study that develops a hierarchical decision model for implementing blockchain technology in emerging economies' health supply chains.

This discursive paper considers the use of restrictive practices in mental health inpatient settings and how these are often prioritised over relational approaches, especially where the diagnostic label of personality disorder intersects with risk.

Key concepts from Orwell’s 1984 are studied for their pertinence to mental health inpatient settings, supporting our argument that restrictive practices arise from dichotomous thinking and externalised fears.

Drawing upon Orwellian themes of power, social control and digital surveillance from 1984, the authors highlight the role of fear in perpetuating restrictive practices under a guise of benevolent care in mental health inpatient settings, especially for those who are diagnosed with a personality disorder. A lack of preparedness to work with complexity in such environments, coupled with a deficit in self-reflexivity and critical thinking, can exacerbate challenges.

To transcend damaging dichotomies and reduce restrictive practices in inpatient settings, the authors make the argument for the adequate preparation and education of the mental health nurse and authentic, collaborative, user-involved care.

The authors use Orwell’s novel to support a critical discourse around those damaging dichotomies and inherent contradictions that contribute to restrictive practice in contemporary mental health settings and to question whose interests’ these restrictive practices serve.

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.

Customer-obsessed organizations put customers first, create exceptional value and enhance business performance. This paper aims to offer a framework for implementing the customer obsession construct.

Using relevant customer value literature, syndicated research and a qualitative analysis, customer obsession insights are offered.

Customer-obsessed companies know their customers’ needs and engage with them to offer the best solutions. Four customer-centric stages are evaluated, and applications of customer obsession in the Now Economy are discussed.

This analysis of customer obsession is largely conceptual and presents a case study in one metropolitan statistical area. Although the findings are insightful, it may not be representative of the US or global health-care market.

Strategic implications relate to a bias for action, types of business obsessions, values alignment and benchmarking. This paper features an in-depth case study on Baptist Health South Florida which assesses customer obsession using a customer value framework.

Customer obsession is a strategic mindset built upon strong leadership, a sound business culture and superior value. While critical to business success, there has been limited scholarly work in this area. This paper fills that gap by providing a managerial approach for understanding this key business priority.

The objective of this study is to examine developments in the discursive practice of non-financial reporting in the public healthcare sector. In doing so, the authors investigate how the main reform foci of productivity and quality are represented, with a specific focus on the patient.

Drawing on critical discourse analysis (CDA), the authors conduct a longitudinal study (2007–2018) of healthcare reporting foci across the five administrative regions responsible for public hospitals in Denmark. The study analyses sixty annual reports and draws on contemporary reform documents over this period. CDA enables a micro-textual analysis, combined with macro-insights and discussions on social practice.

The findings show complex webs of presentation strategies, but in particular two changes occur during the period. First, the patient is centred throughout but the framing changes from productivity and waiting lists to quality and dialogue. Second, in the first years, the regions present themselves as actively highlighting financial and quality concerns, which changes to a passive and indirect form of presentation steered by indicators and patient legislation enforced by central government. This enhances passivity and distance in healthcare regional non-financial reporting where the regions seek to conform to such demands. Simultaneously, however, the authors find a tendency to highlight very different local initiatives, which shows an attempt to go beyond a pure automatic mode of reporting found in earlier studies.

Responding to the literature on both healthcare and financial reporting, this study identifies novel links between micro-level texts and macro-level social practices, enabling insights into the potentially intertwined impacts of public-sector reporting. The authors offer insights into the complexity of the construction of non-financial reporting in the public sector, which has a wider impact and different intentions than private-sector reporting.

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.