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Healthcare has undergone multiple phases in gaining understanding, accepting and implementing quality and safety, with the last 3 decades being crucial and decisive in making progress. During that time, safety has always been quoted along with quality, but the cost of error in healthcare (both in human lives and monetary cost) has been continuing to rise.

This article discusses the authors’ expert perspective in comparison to the industry’s research and practice outputs.

Healthcare has not yet defined quality and safety. This is allowing the misconception that already established quality management systems (QMSs) are fit for safety purposes as well. Even though aviation has acted as a paradigm for healthcare, further alignment in embedding safety management systems (SMS) has yet to be realised.

In this paper, the distinct nature of safety and its detachment of quality is being discussed, along with the need for clear and safety specific processes. Setting common language is the first step in establishing appropriate safety processes within SMSs, operating in tandem with QMSs, to promote patient safety successfully.

Effective teamwork is crucial for patient safety in healthcare. The TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) is a widely used tool for assessing teamwork perceptions. The T-TPQ has been adapted and validated for hospital setting use in several countries. This study aimed to translate and validate the T-TPQ into French for use among Tunisian healthcare professionals, enhancing teamwork assessment and patient safety initiatives.

A rigorous process ensured cultural and linguistic adaptation of the T-TPQ, including back-translation, expert panel review, and pilot testing. 459 healthcare professionals from four hospitals in Kairouan, Tunisia participated. Confirmatory factor analysis (CFA) compared the original five-factor structure with a revised structure based on exploratory factor analysis (EFA).

Both CFA models demonstrated good fit, with no significant difference between them (∆χ² = 22.51, p = 0.79). The original five-factor structure was retained due to its established theoretical foundation. The French T-TPQ exhibited strong internal consistency (α = 0.9). Two-way Random ICCs indicated fair to good test-retest reliability for all the five dimensions (0.633–0.848).

Several limitations should be acknowledged. The use of a questionnaire as a data collection tool is the source of a reporting bias, for fear of being identified or for reasons of “social desirability”. Nevertheless, this social desirability was minimal, as Baker et al. (2010) took steps to mitigate this during the instrument's development. Additionally, for assessing attitudes and perceptions, self-reported measures are deemed more effective, whereas objective measures are advocated for behavioral assessments. Furthermore, the participants were informed of the absence of good or bad answers, the importance of answering as closely as possible, and the confidentiality. Moreover, considering the data collection period, the COVID- 19 pandemic and its potential impact on recruitment, data collection, and participant responses. Although the sample size of 459 met the recommended criteria for conducting confirmatory factor analysis, as suggested by Bentler and Chou (1987) and (Floyd and Widaman, 1995), the COVID-19 pandemic presented challenges in recruitment. The increased workload and stress on healthcare professionals, coupled with staff redeployment and research restrictions within hospitals and care units, likely hindered achieving an even larger sample size. These circumstances also necessitated adjustments to data collection methods to ensure safety and adherence to pandemic protocols. This involved incorporating online surveys option with paper-based questionnaires and implementing stricter hygiene measures during in person data collection. Furthermore, the pandemic impacted the teamwork perceptions as significantly redefined the healthcare environment, placing immense pressure on professionals due to surging patient volumes, staff shortages, and the emotional burden of caring for critically ill individuals. This heightened stress and workload likely influenced teamwork dynamics, potentially fostering both positive adaptations, such as increased cohesion and support, as well as negative consequences like communication breakdowns and decreased morale (Terregino et al., 2023).

We outline significant practical implications for leaders in health care for improving teamwork and patient safety. Or, healthcare leaders can significantly enhance teamwork and patient safety by incorporating the validated French T-TPQ into their improvement strategies. This reliable tool enables the assessment of staff perceptions regarding teamwork strengths and weaknesses, specifically in areas like communication and leadership. By identifying these crucial areas, leaders can implement targeted training programs and interventions. In fact, the existing body of research consistently demonstrates the positive impact of team training interventions, on both teamwork processes and patient outcomes. These interventions have been shown to enhance teamwork skills (Baker et al., 2010; Thomas and Galla, 2013; Weaver et al., 2014). In areas such as communication, leadership, situation monitoring, and mutual support, leading to decreased mortality and morbidity rates (Weaver et al., 2014). Implementing team training programs fosters trust and collaboration around shared goals, contributing to a more effective and safer healthcare environment for both patients and professionals. Additionally, the culturally adapted T-TPQ not only benefits individual healthcare settings but also unlocks opportunities for broader research and collaboration on a global scale. By enabling cross-cultural comparisons and benchmarking, the T-TPQ can deepen our understanding of how teamwork dynamics vary across diverse healthcare environments and cultural contexts. This knowledge is invaluable for tailoring teamwork interventions and training programs to specific populations and settings, ensuring their effectiveness and cultural relevance. Moreover, integrating teamwork training into continuing professional development, interprofessional and medical education initiatives is crucial for cultivating collaborative competencies and building high-performing healthcare teams. Research has shown that interprofessional teamwork experiences significantly enhance collaborative competencies among nursing and medical students, emphasizing the importance of incorporating teamwork training early in healthcare education. This approach equips future healthcare professionals with the necessary skills to navigate complex team environments, ultimately improving patient care quality and mitigating workload issues that contribute to burnout (Simin et al., 2010; Ceylan, 2017; Fox et al., 2018).

The French version of the T-TPQ was semantically equivalent and culturally relevant with adequate test-retest reliability as compared to the English version, expanding its applicability and contributing to understanding teamwork perceptions in this context. The French T-TPQ offers a valuable tool for assessing teamwork, identifying areas for improvement, and implementing interventions to enhance teamwork and patient safety in Tunisia and potentially other French-speaking regions.

The purpose of this paper is to improve the understanding of the social contexts of sustainable Lean culture in healthcare by examining self-efficacy (SE) as a fundamental construct related to the value of perceived readiness, prior education of Lean and the importance of leadership’s system-level support.

A descriptive correlational study was conducted to identify the relationships between SE and Lean readiness factors, SE and prior Lean training, SE and clinical vs administrative roles and SE and perceived system-level support in a large health system.

There was a statistically significant difference in self-reported readiness to use Lean tools between individuals who had received Lean training during their academic education and those who had not; however, their level of education did not impact SE. Lastly, and perhaps most important, the learner who embodies SE also has system-level support.

Future directions of this research, in addition to assessing team readiness as other studies suggest, would be to evaluate individual team member readiness by gauging SE and addressing deficits prior to the deployment of process improvement (PI) projects to promote success and sustainability.

This contributes to the ongoing scholarship of Lean management systems, providing clinical and non-clinical leaders with a contextual understanding of their supportive role in the SE of teams.

This study demonstrates the value of understanding SE of individual team members and how it can contribute to overall improved team outcomes, directly impacting the sustainability of Lean change culture and its promotion of improved patient safety, cost efficiencies and access to care.

This study examines the mediating and moderating effects of business regulatory compliance (BRC) on the association between sustainable supply chain management practices (SSCMP) and operational performance (PERFOP), and how corporate sustainability culture (CSC) serves as a boundary condition to BRC.

This research draws data from 245 firms operating in multiple industries in Ghana. Ordinary Least Square (OLS) was employed to test the direct effects, while Hayes Process Macros was employed to test the indirect and conditional effects among the study variables using a structural equation modelling approach.

The results showed that SSCMP has a direct positive effect on PERFOP. The study further revealed that BRC mediates the relationship between SSCMP and PERFOP. This study found that BRC negatively moderates the association between SSCMP and PERFOP, suggesting that high levels of BRC generate unintended adverse effect on the SSCMP- PERFOP link. However, the results revealed that CSC serves as a boundary condition to BRC.

To the best of our knowledge, this is the first study that emphasizes how the resource-based view and regulatory focus theory interact to explain how different degrees of CSC and BRC impact SSCMP performance outcomes. This study advances research in the sustainability literature, in response to calls for further research in this domain. This study draws decision-makers attention on the need to make sustainability practices an integral part of corporate culture in order to set a business tone that stimulates easy compliance to sustainability requirements.

Efficiency standards, similar to industrial measures like overall equipment effectiveness (OEE), are being used in healthcare systems more and more. Performance indicator models applied to machines assume a constant completion time. However, for human resources, the completion time of a task may vary depending on the stress experienced. This study seeks to bridge this gap by integrating the human behavior of the physician into the performance evaluation.

The paper presents a new algorithm called PerfoBalance that is intended to distribute waiting-patient values among doctors. By maximizing each physician’s stress zones, this method helps to improve their performance as a whole. A thorough case study with medical professionals is carried out to confirm the effectiveness of the suggested methodology. The PerfoBalance algorithm is used in a variety of contexts to divide waiting-patient values among doctors and optimize stress zones.

Experimental results demonstrate a significant improvement in physician efficiency when implementing the PerfoBalance algorithm. The algorithm strategically selects stress zones that contribute to higher performance rates for physicians by optimizing waiting-patient values.

By addressing the undervaluation of human performance difficulties in current efficiency models used in the healthcare industry, this research constitutes a significant contribution to the field. With its launch, the PerfoBalance algorithm offers a fresh viewpoint on waiting-patient value allocation and stress zone management in healthcare settings, hence representing a powerful method for increasing physician productivity.

An “open communication culture” in the workplace is considered a key contributor to high-quality interaction and providing means to address problems at work. We study how the ideals of “open communication” operate in healthcare.

We use discourse analysis to investigate the audio-recorded data from 14 workshop team discussions in older people services.

We found four imperatives concerning the interactional conduct of their colleagues in problematic situations that nursing professionals prefer: (1) Engage in direct communication and avoid making assumptions, (2) Address problems immediately, (3) Deal directly with the person involved in the matter and (4) Summon the courage to speak up. Through these imperatives, the nursing professionals invoke and draw upon the “open communication” discourse. Although these ideals were acknowledged as difficult to realize in practice and as leading to experiences of frustration, the need to comply with them was constructed as beyond doubt.

Workplace communication should be enhanced at a communal level, allowing those with less power to express their perspectives on shaping shared ideals of workplace interaction.

The expectation that an individual will simply “speak up” when they experience mistreatment by a colleague might be too much if the individual is already in a precarious position.

The purpose of this study is to identify and synthesise the best evidence on health-care leaders’ and professionals’ experiences and perceptions of compassionate leadership.

A mixed-methods systematic review was conducted in accordance with the Joanna Briggs Institute methodology for mixed-methods systematic reviews using a convergent integrated approach. A systematic search was done in January 2023 in PubMed, CINAHL, Scopus, Medic and MedNar databases. The results were reported based on Preferred Reporting Items for Systematic Reviews and Meta-analyses. The data was analysed using thematic analysis.

Ten studies were included in the review (five qualitative and five quantitative). The thematic analysis identified seven analytical themes as follows: treating professionals as individuals with an empathetic and understanding approach; building a culture for open and safe communication; being there for professionals; giving all-encompassing support; showing the way as a leader and as a strong professional; building circumstances for efficient work and better well-being; and growing into a compassionate leader.

Compassionate leadership can possibly address human resource-related challenges, such as health-care professionals’ burnout, turnover and the lack of patient safety. It should be taken into consideration by health-care leaders, their education and health-care organisations when developing their effectiveness.

This review synthesised the knowledge of compassionate leadership in health care and its benefits by providing seven core elements of health-care leaders’ and professionals’ experiences and perceptions of compassionate leadership.

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 aims to examine the effects of Internet of Things (IoT) technology on efficiency and patient care in Italian and Israeli intensive care units (ICUs). The goal is to study how IoT might improve care settings by controlling health dynamics and responding to life-threatening circumstances.

This survey-based research explores IoT use, challenges and adaptability in ICUs in both countries. Interviews and surveys of ICU health-care workers are used to get both quantitative and qualitative data on integrating experiences and perspectives.

The research found significant variations between Italy and Israel due to technology infrastructures and health-care practices. Israel shows a more concentrated deployment in a major medical centre with advanced but limited uptake, whereas Italy shows application throughout ICUs highlighting regional health-care system disparities. Interoperability, data security and IoT training are common difficulties.

This research has limitations. One drawback is the geographical dispersion of study sites, with a bigger sample size in Italy than in Israel. This discrepancy may affect findings applicability. However, these preliminary findings provide a foundation for further research into the complexities of deploying IoT in various health-care settings.

This study compares IoT integration in two national health-care systems, adding to health-care technology literature. Regional variations affect technology adoption, but IoT may enhance ICU operations and patient care, according to one research. This study helps health-care practitioners, academics and policymakers understand the pros and cons of IoT in health care.

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.