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Although the quality of health-care infrastructure and equipment influences patient’s overall health-care experience, health-care infrastructure and equipment are not always managed and maintained with the attention required. This is due mainly to the complexity of health-care infrastructure and equipment and shortage of maintenance budget. This study aims to determine if patient’s satisfaction of core health-care business is mediated by the quality of health-care infrastructure and equipment.

This cross-sectional study comprises 622 adult patients at the Physician OPD and Polyclinic of Komfo Anokye Teaching hospital, Tamale Teaching hospital and Cape Coast Teaching hospital in Ghana. Structural equation model Smart PLS was used to analyse the data.

The study results showed that the quality of health-care infrastructure and equipment has a positive significant influence (mediation) on the relationship between health-care delivery and patient’s satisfaction as well as the relationship between adequacy of health-care resources and patient’s satisfaction. However, it was shown not to have a positive significant influence (mediation) on the relationship between quality of health-care personnel and patients’ satisfaction as well as health-care administrative process and patient’s satisfaction.

First, the study findings are centred on cross-sectional data, which capture the opinion of the patients at a specific time period instead of over a period of time. Consequently, in future, though difficult to achieve, a longitudinal study can be piloted to provide more insight. Second, the data was collected from only one country (Ghana); thus, the ability to generalise the results may be a challenge.

The implication of this study is that there is the need to prudently maintain hospital infrastructure and equipment in good working condition as it has a positive effect on patients’ satisfaction of their overall health-care experience.

Most studies have concentrated on patient’s health-care experience. This study extends the knowledge of patient’s health-care experience by determining the mediating role of quality of health-care infrastructure and equipment on the relationship between patient’s satisfaction and core health-care business. There are limited studies of such nature in Ghana. Therefore, this study will provide invaluable empirical data for the health-care sector of a developing African country.

Most UK ambulance services undertake remote assessments of 999 calls with nurses and paramedics to manage demand and reduce inappropriate hospital admissions. However, little is known about the differences in the types of cases managed by the two professions comparatively, their clinical outcomes, and the quality and safety they offer.

The retrospective descriptive study analysed data collected at Welsh Ambulance Services University NHS Trust (WAST) from prioritisation, triage, and audit tools between the 17th May 2022 to 8th November 2022. A total of 21,076 cases and 728 audits were included for review.

There was little difference in the type and frequency of the presenting complaints assessed, and clinical outcomes reached in percentage terms. Whilst paramedics had more highly compliant call audits and fewer non-compliant call audits, there was, again, little difference in percentage terms between the two, indicating positive levels of safety across the two professional groups.

There continues to be a substantial difference between UK paramedics to those in the Middle East, the United States, and some African nations, which may limit the applicability of findings. This study also looked at a six-month window from only one UK service using one type of prioritisation and triage tool. Future research could explore longer periods from multiple services using various tools. It is important to note that this study did not link outcome data with primary, secondary or tertiary care settings. Thus, it is impossible to determine if the level of care aligned closely with the final diagnosis.

The practical implications of this work include better workforce planning for agencies who have perhaps only employed one type of clinician or a reaffirmation to those who have employed both. The authors suggest that the training and education of both sets of clinicians could remain general in nature, with no overt requirement for specificity based on professional registration alone. Commissioners and stakeholders in the wider health economy should consider ensuring equitable access to alternative pathways for patients assessed by both nurses and paramedics.

It has been posited that UK nurses and paramedics are, by virtue of their consistency in education, skill set, licensure, and general experience, both able to achieve safe and effective remote outcomes in 999 settings. This study provides evidence to support that hypothesis. These results say more about the two professions' ability to work together rather than just the professions themselves. The multidisciplinary team approach is well-established in acute care settings, and is broadly considered to improve communication, coordination decision making, adherence to up-to-date treatment recommendations, and be positive for shared learning and development for younger colleagues.

Most UK services use a mix of nurses and paramedics; however, little is known about the differences in the types of cases managed by the two professions comparatively, their clinical outcomes, and the quality and safety they each offer. The most recent studies of this nature were published in 2003 and 2004 and looked only at low-acuity 999 calls when remote assessment was not even an established role for UK paramedics. This study updates the literature, identifies areas for future research, and applies to the international setting for the most part.

This paper aims to assess the influence of nursing leadership style on error management culture (EMC).

This scoping review was conducted following the integrative review methodology of the Joanna Briggs Institute (JBI) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). PubMed, CINAHL, Scopus, Web of Science, Embase and EBSCO databases were systematically searched to identify studies on nursing leadership, error management and measurement, and error management culture. The studies’ methodological quality was then assessed using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies.

Thirteen manuscripts were included for review. The analysis confirmed that nursing leadership plays an important role in EMC and nurses’ intention to report errors. Three emerging themes were identified: 1) leadership and EMC; 2) leadership and the intention to report errors; and 3) leadership and error rate.

A major limitation of the studies is that errors are often analyzed in a transversal way and associated with patient safety, and not as a single concept.

Healthcare managers should promote training dedicated to head nurses and their leadership style, for creating a good work environment in which nurses feel free and empowered to report errors, learn from them and prevent their reoccurrence in the future.

There is a positive relationship between nursing leadership and error management in terms of reduced errors and increased benefits. Positive nursing leadership leads to improvements in the caring quality.

The viewpoint essay focusses on the significance of integrated care (IC) for chronic pain in India, in an attempt to reflect on how pain management and care can be made more accessible and available to patients.

This reflective essay invites looking at chronic pain beyond biomedical perspectives. Insights from the medical humanities and the social sciences are used to emphasise chronic pain as a psychosocial and socio-political phenomenon and not just a biomedical category.

The essay argues that there are several challenges and barriers to the recognition and validation of chronic pain as a speciality.

IC has not received sufficient attention in the Indian context, where medical curricula and training do not sufficiently include an understanding of the multi-faceted aspects surrounding chronic pain. By highlighting the role of humanistic approaches to effectively bridge the gap, this viewpoint essay illustrates the significance of drawing on an integrated or holistic healthcare framework.

This systematic review aimed to identify and categorize applications using Fast Healthcare Interoperability Resources (FHIR) to support activities outside of direct healthcare provision.

A systematic electronic search was performed, and 53 studies were included after the selection process.

The results show that FHIR is being used to support (1) clinical research (i.e. clinical research based on interventional trials, data interoperability to support clinical research and advanced communication services to support clinical research), (2) public health and (3) medical education. Despite the FHIR potential to support activities outside of direct healthcare provision, some barriers were identified, namely difficulties translating the proposed applications to clinical environments or FHIR technical issues that require further developments.

This study provided a broad review of how FHIR is being applied in clinical activities outside of direct clinical care and identified three major domains, that is, clinical research, public health and medical education, being the first and most representative in terms of number of publications.

This study aims to fully assess the readiness for Lean Six Sigma (LSS) and Quality Performance Improvement (QPI) in an Italian Public Healthcare ecosystem.

Drawing from previously established survey development and adaptation protocols, a replication study was carried out; Lean, Six Sigma and QPI were extracted and validated through confirmatory factor analysis in an Italian Public Healthcare setting, with a sample of health professionals from the Campania region.

This study reports the adaptation of an existing scale for measuring LSS and QPI in an Italian public healthcare organisation. This analysis extracts six conceptual domains and constitutes an original adaptation of an existing scale to assess the readiness to adopt Lean, Six Sigma and Quality Performance in Italian Public Health Organizations. The constructs show strong levels of internal consistency, as demonstrated by each item factor loading and each subscale reliability.

Managers, policymakers and academics can employ the proposed tool to assess the public healthcare ecosystem’s capability to implement LSS initiatives and strategies to improve quality performance.

This is one of the first studies to assess cross-regional organisational readiness for LSS and QPI in an Italian Public Healthcare environment at this scope and level.

The most challenging aspect of hospital design is the creation of an environment that heals rather than the one acting as a barrier to healing. Much has not been done in the aspect of ascertaining the level of impact “indoor environmental quality (IEQ)” has on building occupants in healthcare facilities. Therefore, this study aims to investigate the impact of IEQ on patients' health and well-being.

The study investigates the hypothesis that four IEQ parameters (thermal quality, acoustic quality, lighting quality and indoor air quality [IAQ]) influence patients' overall satisfaction with the performance of hospital wards. Questionnaire responses were sought from the patients as the main occupants of hospital ward buildings. A proposed weighted structural model for IEQ establishing the relationship between IEQ parameters, patients' overall satisfaction and patients' health outcome was analyzed using structural equation modeling (SEM).

The most influential IEQ parameters on patients' overall satisfaction with IEQ in hospital wards are thermal quality, IAQ and lighting quality. The findings from this study revealed that the parameters of influence on patients' overall satisfaction and health outcomes vary with hospital ward orientation and design configuration.

This study has explored the need for the integration of all factors of IEQ at the building design stage towards providing a hospital environmental setting that reflects occupants' requirements and expectations and also promotes patient healing processes. This should be the focus of architects and healthcare managers and providers.

The purpose of this study is to explore the lived experiences of the constraints of older adult family caregivers with chronic diseases in caring for and accessing health services during the COVID-19 pandemic.

This study used the descriptive phenomenology qualitative method. The sampling method was purposive sampling involving 16 older adult family caregivers.

The results of this study showed three themes such as difficulties in health services in hospitals during the COVID-19 pandemic (complaints of services provided by doctors, older adult treatment control problems and difficulty getting to hospital health facilities); difficulties accompanying taking older adult medicine (older adult non-compliance response to taking medication and older adult medicine assistance); and psychosocial complaints caring for and accompanying the older adult (negative emotions for the older adult, difficulty interacting with the older adult and the economic burden of caring for the older adult).

Barriers to family caregivers in caring for older adults with chronic diseases can help health-care service providers understand and support families caring for and assisting older adults, which may contribute to the quality of life and care for both family caregivers and older adults.

This study showed that Indonesian family caregivers faced difficulties caring for and living with older adults with chronic diseases during the pandemic. Family caregivers’ experiences are essential when developing an intervention to support and manage health care for older adults with chronic illnesses.

In recent years, in research and policy circles, there is growing interest in the subject of speaking up (and silence) within the health sector, and there is a consensus that it is a major issue that needs to be addressed. However, there remain gaps in our knowledge and while scholars talk of a voice system – that is the existence of complementary voice channels designed to allow employees to speak up – empirical evidence is limited. We seek to explore the notion of a voice system in a healthcare organisation as comprising structures and cultures as seen from different stakeholder perspectives. What do they see and how do they behave and why? To what extent do the users see a voice system they can access and easily navigate?

Interviews and focus groups were conducted with a voice stakeholder group (e.g. designers of the system from senior management and HR, which comprised 23 staff members) as well as those who have to use the system, with 13 managers and 26 employees from three units within a metropolitan hospital: an oncology department, an intensive care unit and a community health service. Overall, a total of 62 staff members participated and the data were analysed using grounded theory to identify key themes.

This study revealed that although a plethora of formal voice structures existed, these were not always visible or accessible to staff, leading to confusion as to who to speak up to about which issues. Equally other avenues which were not designated voice platforms were used by employees to get their voices heard.

This papers looks at the voice system across the organisation rather than examining a specific scheme. In doing so it enables us to see the lived perceptions and experiences of potential users of these schemes and their awareness of the system as a whole.

This study aims to explore the influence of health-care service quality on customers’ perceived value, satisfaction, effectiveness and behavioural intention concerning district health centres (DHCs) in Hong Kong. This research also intends to assess customers’ perception of the subsidy scheme and its influence on the relationships amongst the aforementioned constructs.

The convenience and snowball sampling approaches were adopted, and the self-administered questionnaire was sent to 309 customers of DHCs.

Service quality attributes in terms of staffing and procedures positively increased customers’ perceived value and staffing, procedures and operations. Physical facilities positively promoted customers’ satisfaction, consequently improving DHCs’ effectiveness and behavioural intention. However, core treatments and services of DHCs did not impact customers’ perceived value and satisfaction. Furthermore, customers receiving subsidies exhibited a more positive perception than those without subsidies.

Health-care organisations are advised to strategically allocate resources (staffing, facilities and procedures and operations management) to optimise overall performance outcomes. DHC operators could reinforce the core services of DHCs and health-care voucher subsidies to local citizens so as to enhance the effectiveness of DHCs and behavioural intention of customers.

This study integrates the input–process–output approach in measuring the effectiveness of and customers’ behavioural intention towards newly established DHCs.