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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 document students’ supply chain solutions developed through the internship hackathon program. The study profiled innovative solutions developed by university students in Kenya to solve health supply chain logistics challenges during and beyond COVID-19. This is done by exploring students’ experience in developing sustainable logistics and supply chain management capacity-building programs in a low-middle-income country (LMIC).

This study used a qualitative approach to explore the experiences and perceptions of students and mentors who participated in a hackathon program. The study followed a cross-sectional descriptive survey design, collecting data from the participants through online questionnaires. The data were analyzed and presented using thematic analysis and narrative techniques.

Findings provide preliminary evidence for narrowing the gap between theory and practice through a hackathon internship blended with a mentorship program. Assessment of this program provides evidence for developing solutions toward ensuring the availability of essential medicine in LMICs during a pandemic such as COVID-19 by students. The profiled solutions demonstrate a broader perspective of innovative solutions of university students, mentors and potential opportunities for a triple helix approach to innovation for health supply chain system strengthening.

This original study provides evidence for advancing contribution to developing innovative solutions through partnerships between investors, universities and industry practitioners interested in mentoring students in the health-care supply chain during COVID-19 in LMICs. Specifically, contingency factors that affect the implementation of innovative programs during and beyond global pandemics such as COVID-19 by students’ innovators are identified, and implications for policy action are discussed based on the praxis of sensemaking.

This study examines a novel approach that combines internship, mentorship and hackathon projects for logistics and supply chain students in LMICs. The approach aims to bridge the gap between theory and practice and to create innovative solutions for essential medicines during and after COVID-19. The study urges more resources for supporting such programs, as they benefit both academia and industry. The study also argues that hackathon internship programs can help the logistics and supply chain industry adapt to the post-pandemic era. The study offers insights for investors, universities and practitioners in the health-care industry.

This study shows how to develop innovative solutions for the health-care supply chain during COVID-19 in an LMIC through partnerships between investors, universities and industry practitioners who mentor students. The study identifies the contingency factors that influence the success of such programs during and beyond global pandemics such as COVID-19 and discusses the policy implications based on the sensemaking praxis of the student innovators.

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.

This study aims to investigate the consumer behavior toward telemedicine services in India during the COVID-19 pandemic onset. With lockdown restrictions and safety concerns in visiting brick-and-mortar clinics or hospitals during the pandemic, Telemedicine had emerged as a potent alternative for seeking redressal to health issues. Based on theory and focus interviews with the telemedicine users, the researchers proposed a model to understand the intent and actual usage of telemedicine in India.

The cross-sectional study undertaken used a questionnaire designed on a seven-point Likert scale and administered to respondents with the objective of identifying the determinants of intent and actual usage of telemedicine services. Simple random sampling was used to collect primary data. The data was cleaned and finally a sample of 405 responses complete in all respects was considered for analysis. The questionnaire comprised of 34 items and following the recommendation of Hair et al. (2016), which says the minimum sample size in structural equation modeling should be ten times the number of indicator variables, a sample size of 405 was deemed adequate.

The research paper finds that performance expectancy, attitude, credibility and self-efficacy positively impact the intention of consumers to use telemedicine services. As the effort expectancy or risk perception toward telemedicine increases the intent and actual usage of telemedicine decreases. The intention to use telemedicine emerged as a strong predictor of the actual usage of telemedicine. Intent to use telemedicine was explained 81.4% by its predictors of performance expectancy, effort expectancy, attitude, risk, credibility and self-efficacy, and actual usage was explained 79.9% by its predictors. This study also reports that telemedicine was found to be popular among chronic as well as episodic patients though the preference was skewed in favor of the episodic patients. One of the advantages of telemedicine is its availability round the clock, and the study found that 8 a. m. to 12 noon time slot as the most preferred slot for seeking telemedicine services.

Chang (2004) opined that telemedicine can fulfill the needs of all stakeholders: citizens, health-care consumers, medical doctors and health-care professionals, policymakers, and so on. Considering the promise telemedicine holds, this realm must be studied and leveraged to the full potential. The study found that patients were using telemedicine even for their day-to-day aliments. This indicates a growing popularity of telemedicine and as such an opportunity for telemedicine companies to leverage it. In India, pharmaceutical companies cannot give commercial advertisements for medicines, and the same can only be sold through a registered medical practitioner’s prescription. As such there is total dependency on the medical practitioner for the sale of medicines. Telemedicine companies offer services of home delivering medicines clubbed with medical consultation thus giving them forward integration in their business models. Using telemedicine the patients had control over the timings of the services offered, and as such the waiting time to get a consultation and subsequent treatment was reduced considerably. Best medical advice from across the globe is available to the patient at less cost. Medical practitioners also stand to benefit as they can treat a variety of cases, collaborate among the medical fraternity and give consultation safely in case of fatal contagious diseases.

This study points to a definite growing popularity of telemedicine services not only in episodic patients but also chronic patients. Telemedicine with its unique advantages holds the promise to grow exponentially in the future and is a compelling health-care segment to focus on for delivering health-care solution to the geographically distant consumers.

Nurse leaders are challenged by ethical issues in today’s complex health-care settings. The purpose of this study was to describe and analyze key elements of moral distress identified by nurse leaders from health-care systems in the USA, Germany, Austria and Switzerland. The aim was to develop an understanding of distressing ethical issues nurse leaders face in the USA and three German-speaking European countries.

This descriptive cross-sectional study surveyed a convenience sample of nurse leaders in the USA, Germany, Austria and Switzerland. The voluntary, anonymous survey also included qualitative questions and was distributed using the Qualtrics® platform. A thematic analysis of the qualitative data in each country was carried out and a comparative analysis identified similarities and differences between the groups of nurse leaders comparing the US data to that from three German-speaking European countries.

The survey was completed by 316 nurse leaders: Germany, Austria, and Switzerland (n = 225) and the USA (n = 91). Similar themes identified as causing all nurse leaders moral distress included a lack of individual and organizational integrity, hierarchical and interprofessional issues, lack of nursing professionalism, patient care/patient safety concerns, finances negatively impacting care and issues around social justice. Within these six themes, there were also differences between the USA and the three German-speaking European countries.

Understanding the experiences associated with distressing ethical situations can allow nurse leaders and organizations to focus on solutions and develop resilience to reduce moral distress in the USA and three German-speaking European countries.

Applying the value-attitude-behavior (VAB) model, this study investigated how perceived utilitarian and hedonic values (i.e. novelty and emotion) affect individuals' attitudes toward medical hotels and how these attitudes, in turn, influence their intentions to stay at medical hotels. The current study also explored the moderating impact of overall health status on the relationships between perceived utilitarian, novelty and emotional values and attitudes toward medical hotels.

The data collected from 351 individuals who spent a night in a hospital to undergo medical treatment was used in conducting structural equation modeling to evaluate the research model and test the study hypotheses.

The study results revealed that perceived utilitarian, novelty and emotional values exerted a positive influence on individuals’ attitudes toward medical hotels, consequently enhancing their intention to stay. Additionally, significant moderating impacts of overall health status on the associations between perceived utilitarian, novelty and emotional values and attitudes toward medical hotels were observed.

The study findings provide useful guidance for professionals, such as operators, marketers and managers in medical hotels. These insights can improve operational and marketing strategies, benefiting both the industry and healthcare accommodation seekers.

This study is among the first to empirically assess a theoretical model that explored the influence of individuals' value perceptions within the realm of medical hotel establishments.

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.

The purpose of this paper is to provide a systematic review of the current state of physician leadership. Theory of expert leadership (TEL) was applied to explore the effects of physician inherent knowledge, industry experience and leadership capabilities on leader behaviors and outcomes.

This review (August 2011–February 2022) applied the preferred reporting items for systematic review and meta-analysis strategy. Our search began with 3,537 studies and a final sample of 12 articles.

The findings offer a number of studies that note the relationship between physician leadership and the three dimensions of TEL. How influential these are on leadership behaviors and health-related outcomes varies. We also found a number of studies that described general physician leadership behaviors that were not directly linked to factors of TEL, as well as two additional themes: leader identity and trust.

To the best of the authors’ knowledge, this is the first systematic review that has applied a highly cited theory (i.e. TEL) to the data and the first that has focused solely on a U.S. population. These findings offer healthcare organizations insight into the potential strengths and challenges of physician leadership.

This paper is one of the first studies to examine specificities, including limits of mindfulness at work in an African organisational context, whilst dealing with the ongoing COVID-19 pandemic. It specifically addresses the role of organisational and managerial support systems in restoring employee wellbeing, social connectedness and attachment to their organisations, in order to overcome the exclusion caused by the ongoing pandemic.

The study uses a qualitative research methodology that includes interviews as the main data source. The sample comprises of 20 entrepreneurs (organisational leaders) from Ghana and Nigeria.

The authors found that COVID-19-induced worries restricted the practice of mindfulness, and this was prevalent at the peak of the pandemic, particularly due to very tough economic conditions caused by reduction in salaries, and intensified by pre-existing general economic and social insecurities, and institutional voids in Africa. This aspect further resulted in lack of engagement and lack of commitment, which affected overall team performance and restricted employees’ mindfulness at work. Hence, quietness by employees even though can be linked to mindfulness was linked to larger psychological stress that they were facing. The authors also found leaders/manager’s emotional intelligence, social skills and organisational support systems to be helpful in such circumstances. However, their effectiveness varied among the cases.

This paper is one of the first studies to establish a link between the COVID-19 pandemic and mindfulness limitations. Moreover, it is a pioneering study specifically highlighting the damaging impact of COVID-19-induced concerns on leader–member exchange (LMX) and team–member exchange (TMX) relationships, particularly in the African context. It further brings in a unique discussion on the mitigating mechanisms of such COVID-19-induced concerns in organisations and highlights the roles of manager’s/leader’s emotional intelligence, social skills and supportive intervention patterns. Finally, the authors offer an in-depth assessment of the effectiveness of organisational interventions and supportive relational systems in restoring social connectedness following a social exclusion caused by COVID-19-induced worries.

Given the complex nature of integrated care systems (ICSs), the geographical spread and the large number of organisations involved in partnership delivery, the importance of leadership cannot be overstated. This paper aims to present novel findings from a rapid realist review of ICS leadership in England. The overall review question was: how does leadership in ICSs work, for whom and in what circumstances?

Development of initial programme theories and associated context–mechanism–outcome configurations (CMOCs) were supported by the theory-gleaning activities of a review of ICS strategies and guidance documents, a scoping review of the literature and interviews with key informants. A refined programme theory was then developed by testing these CMOCs against empirical data published in academic literature. Following screening and testing, six CMOCs were extracted from 18 documents. The study design, conduct and reporting were informed by the Realist And Metanarrative Evidence Syntheses: Evolving Standards (RAMESES) training materials (Wong et al., 2013).

The review informed four programme theories explaining that leadership in ICSs works when ICS leaders hold themselves and others to account for improving population health, a sense of purpose is fostered through a clear vision, partners across the system are engaged in problem ownership and relationships are built at all levels of the system.

Despite being a rigorous and comprehensive investigation, stakeholder input was limited to one ICS, potentially restricting insights from varied geographical contexts. In addition, the recent establishment of ICSs meant limited literature availability, with few empirical studies conducted. Although this emphasises the importance and originality of the research, this scarcity posed challenges in extracting and applying certain programme theory elements, particularly context.

This review will be of relevance to academics and health-care leaders within ICSs in England, offering critical insights into ICS leadership, integrating diverse evidence to develop new evidence-based recommendations, filling a gap in the current literature and informing leadership practice and health-care systems.