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Health care systems aspire to adopt integration strategies shifting the focus from acute care to a broader focus on community-based health and social services. Real-world examples demonstrating effective delivery of integrated care are essential.

In this article, we introduce UHN Connected Care Hub, an innovative model of care comprising an interdisciplinary team designing sustainable, shareable practices across the continuum of care alongside community and health organization partnerships.

We describe UHN Connected Care Hub’s ability to identify patients from high-risk population and collaborate to delivery timely care, in detailing the real world experience of this model of care in the organization of a centralized system of micro-clinics to administer a therapeutic for pre-exposure prophylaxis against COVID-19 (Tixagevimab/cilgavimab [Evusheld]) in a population of immunocompromised patients.

Having a centralized system of micro-clinics for care delivery presents opportunities for increased adaptability, patient accessibility, enhanced community partnerships and integratedness. Expansion in the scope of services could also create new opportunities in preventative therapies for optimizing the cost effectiveness and quality of health care provided at the population level.

There is limited evidence on how to efficiently deliver integrated care, particularly to vulnerable and co-morbid patients. We discuss how dynamic organizations with proper infrastructure and a network of healthcare partnerships may allow a more fluid response to rapidly changing policies and procedures and facilitate preparedness for future health care crises or pandemics.

While digital transformation holds immense promise, organizations often fail to realize its benefits. This study aims to address how policies for digital transformation benefits realization are translated into practice.

The authors apply a qualitative, comparative case study of two large, public-sector health care organizations in Sweden. Through document and interview data, the authors analyze the process of translation.

The study finds that practice variation is primarily caused by two types of decoupling: policy-practice and means-ends. Contrary to previous studies, coercion in policy compliance is not found to decrease practice variation.

The limitations primarily stem from the empirical selection of two large public health-care organizations in Sweden, affecting the study’s generalizability. Reducing practice variation is more effectively achieved through goal alignment than coercion, leading to implications for the design of governance and control.

Policymakers should, instead of focusing on control-related compliance, work to align organizational objectives and policies to decrease practice variation for successful benefits realization.

The study contributes to better benefits realization of digital transformation initiatives in health care. As such, the authors contribute to a better functioning and more transformative health care in times of increased demand and decreased supply of health-care services.

The study challenges conventional wisdom by identifying that coercion is less effective than goal alignment in reducing practice variation, thereby enhancing the understanding of policy implementation dynamics in health-care settings.

Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a shift from acute, episodic and reactive hospital-centered care toward longitudinal, person-centered and proactive home-centered care. The purpose of this paper is to contribute to the knowledge of a comprehensive development strategy for designing and providing home-centered care of older people.

The study design is based on qualitative research with an inductive approach. The authors study development initiatives at the national, regional and local levels of the Swedish health and social care system. The data collection methods included interviews (n = 54), meeting observations (n = 25) and document studies (n = 59).

The authors describe findings related to policy actions and system changes, attempts to achieve collaboration, integration and coordination, new forms of care offerings, characteristics of work settings at home and differences in patients' roles and participation at home and in the hospital.

The authors suggest home-centered care as a solution for providing person-centered and integrated care of older people and give examples of how this can be achieved.

The authors outline five propositions for research and development related to national policies, service modularity as a solution for customized and coordinated care, developing human resources and infrastructure for home settings, expanding services that enable older people living at home and patient co-creation.

This paper aims to identify the kind of internal climate leaders should offer health-care professionals to promote a patient safety culture in public hospitals managed by social health organizations in Brazil.

Two surveys were applied to health-care professionals working at three Brazilian public hospitals. The internal climate survey reached 1,013 respondents, and the patient safety culture survey reached 1,302 participants. Both factor and regression analyses were used to analyze the study model and determine how internal climate influences patient safety culture.

Results indicate that to promote a patient safety culture among health-care professionals, leaders should generate an internal climate based on trust to foster pride in working in the hospital. Possibly, the trust dimension is the most important one and must be developed to achieve job satisfaction and provide better services to patients.

All the hospitals studied were managed by the same Organização Social de Saúde. Due to the limited responses concerning the respondents’ profiles, demographic variables were not analyzed.

This research reveals that the trust and pride dimensions can most strongly influence a positive patient safety culture, helping hospital leaders face this huge managerial challenge of consistently delivering high standards of patient safety.

This research studies the promotion of a patient safety culture in public hospitals managed by social health organizations, characterized by greater flexibility and autonomy in health-care management and by a greater need for accountability.

Integrated care (IC) is mainly studied from the perspectives of organisations or employees. However, less research is focussed on how patients themselves experience person-centred (PC) IC in practice. This context-specific, small-scale study examines what PC-IC means to older patients who went through joint replacement surgery (JRS).

The data consists of ten in-depth interviews of older patients, focussing on their experiences of care during their patient journey related to joint knee or hip replacement surgery. The data were analysed with thematic analysis.

Three central dimensions of PC-IC for older patients were identified: information sharing, continuity of care and compassionate encountering. Human validation and compassionate encountering were experienced as important aspects of PC-IC. Compassionate encountering was concretised through professionals’ very small everyday practices, which made the patient feel comfortable and respected. Instead, probably due to the medical and quite straight-forward nature of the joint replacement care process, patients seem to be pleased to trust the expertise of professionals and did not necessarily expect an active role or participation in the decision-making.

This Finnish case study focusses on the patients’ authentic perceptions of what is central to person-centred IC in the specific context of JRS.

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.

Designing and developing responsible business practices can create various tensions for service organizations. The purpose of this research is to develop a deeper understanding of the relationship between customer engagement (CE) and responsible business practices (e.g. environmental, social and/or governance [ESG], corporate social responsibility [CSR] and diversity, equity, and inclusion [DEI]) and explore customer engagement tensions that service organizations may face.

This research develops a list of CE-related responsible business practice tensions and empirically explores their relevance through in-depth interviews with nine ESG professionals.

This paper makes three important contributions. First, we find support for nine distinct but related tensions with implications for CE that organizations must navigate when pursuing responsible business practices. Second, interview participants provide some suggestions for tackling these tensions, which we support with relevant theories. Finally, we develop a conceptual framework that may stimulate future service research and inform the implementation of ESG strategies.

To the best of the authors’ knowledge, this research is the first to conceptualize and empirically explore the tensions that emerge between responsible business practices and CE. The authors develop a novel analysis of the CE-related tensions that emerge when pursuing an ESG strategy.

The findings are based on a small sample of ESG professionals. Future research may take a quantitative approach to further evaluate the role that these tensions play in engaging customers.

This research provides a conceptual framework that may guide ESG professionals in understanding, framing and navigating CE-related tensions when pursuing responsible business practices.

A social benefit may be found when service organizations are better able to successfully navigate CE-related tensions when pursuing responsible business practices.

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.

This study aims to investigate and test the impact of competitive priorities, in terms of quality, speed, dependability, flexibility, cost and patient engagement, on patient satisfaction with healthcare services. It considers patients’ rather than managers’ points of view to collect responses about competitive priorities.

This research employed a cross-sectional survey design to analyze a sample of customers through an empirical study of 488 patients in Qatar’s healthcare service context.

The confirmatory factor analysis results show that competitive priorities and engagement positively and significantly impact patient satisfaction.

Researchers can use this methodology to explore the role of competitive priorities in different service contexts and sectors. The researchers conducted the study in Qatar; therefore, the results are not generalizable to all healthcare sectors. However, regardless of geographic location, the research approach can be used in healthcare.

Managers can employ the developed scales to diagnose competitive priorities and improve customer service experiences.

The paper is original as it suggests using competitive priorities as a measurement tool for predicting patient satisfaction compared to prior research that mostly measured competitive priorities based on internal perspectives (managers’ perspectives). Further, this paper is original because it depends on the external perspective (customers’ perspective) for the competitive priorities for measuring patient satisfaction.

The purpose of this investigation is to scrutinize the unexplored realm concerning the interplay of hospital brand gestalt on patient satisfaction and revisit intentions.

A self-administered online survey was conducted with 227 patients who had stayed at and received health-care services from a private hospital in the city of Manado, Indonesia, within the past 12 months. The quantitative data were subsequently analyzed using a structural equation model with the assistance of Smart PLS statistical software.

The results suggest that the hospital brand gestalt significantly and positively influences patient satisfaction, which, in turn, leads to patients’ intentions to revisit. Furthermore, patient satisfaction serves as a significant mediator in the relationship between brand gestalt and revisit intentions.

This study enhances the comprehension of brand gestalt’s influence on customer attitudes and behaviors within the health-care context, contributing to the expanding body of literature concerning holistic brand perception. For health-care providers, the study underscores the significance of creating a uniform and distinctive brand experience to boost patient satisfaction and cultivate loyalty. In summary, this study paves the way for strategic branding initiatives in health care, ultimately enhancing patient experiences and organizational outcomes.

For health-care providers, this study emphasizes the importance of crafting a consistent and differentiated brand experience to enhance patient satisfaction and foster loyalty. Overall, this study opens avenues for strategic branding efforts in health care, ultimately improving patient experiences and organizational outcomes.

While there is a growing interest in the role of brand gestalt in marketing research, there is still a need for more empirical research to explore the link between brand gestalt, customer satisfaction and revisit intention. Surprisingly, to the best of the authors’ knowledge, no previous studies have investigated the role of brand gestalt in the context of health care.