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This paper explores Lean Six Sigma principles and the DMAIC (define, measure, analyze, improve, control) methodology to propose a new Lean Six Sigma 4.0 (LSS 4.0) framework for employee occupational exams and address the real-world issue of high-variability exams that may arise.

This study uses mixed methods, combining qualitative and quantitative data collection. A detailed case study assesses the impact of LSS interventions on the exam management process and tests the applicability of the proposed LSS 4.0 framework for employee occupational exams.

The results reveal that changing the health service supplier in the explored organization caused a substantial raise in occupational exams, leading to increased costs. By using syntactic interoperability, lean, six sigma and DMAIC approaches, improvements were identified, addressing process deviations and information requirements. Implementing corrective actions improved the exam process, reducing the number of exams and associated expenses.

It is important to acknowledge certain limitations, such as the specific context of the case study and the exclusion of certain exam categories.

The practical implications of this research are substantial, providing organizations with valuable managerial insights into improving efficiency, reducing costs and ensuring regulatory compliance while managing occupational exams.

This study fills a research gap by applying LSS 4.0 to occupational exam management, offering a practical framework for organizations. It contributes to the existing knowledge base by addressing a relatively novel context and providing a detailed roadmap for process optimization.

The purpose of this paper is to conceptualise a research study to examine leadership as a relational concept between leaders and followers. The context is within surgical practice examining how motivated consultant surgeons are to lead junior doctors and which type of leadership style they use. From a follower perspective, the motivation of junior doctors will be explored, and their leadership preferences will be correlated with those of the actual style of consultant surgeons.

In this paper, the authors provide a detailed description of the methods for an international quantitative research study, exploring sequentially how motivated consultant surgeons are to lead and how leadership styles impact on the motivation of junior doctors. The objectives, method and data collection of this study are explained, and the justification for each method is described.

The findings for this outline study illustrate how critical it is to redefine leadership as a relational concept of leader and follower to ensure adequate support is provided to the next generation of consultant surgeons. Without consideration of the relational model of leadership, attrition will continue to be a critical issue in the medical workforce.

The research limitations are that this is a proposed quantitative study due to the need to collect a large sample of data from surgeons across the UK, Egypt and Germany. This research will have immense implications in developing new knowledge of leadership as a relational concept in medicine and healthcare. This study additionally will impact on how leadership is conceptualised in the curriculum for specialist surgical practice.

The practical implications are that relational leadership is supportive of generating a supportive leadership culture in the workplace and generating more effective teamwork.

To the best of the authors’ knowledge, this is the first study of its kind to look at a relational model of leadership in surgical practice between consultant surgeons and surgical trainees. This study will also identify any specific country differences between the UK, Germany and Egypt.

Today, e-government (electronic government) applications have extended to the frontiers of health-care delivery. E-Nabız contains personal health records of health services received, whether public or private. The use of the application by patients and physicians has provided efficiency and cost advantages. The success of e-Nabız depends on the level of technology acceptance of health-care service providers and recipients. While there is a large research literature on the technology acceptance of service recipients in health-care services, there is a limited number of studies on physicians providing services. This study aims to determine the level of influence of trust and privacy variables in addition to performance expectancy, effort expectancy, social influence and facilitating factors in the unified theory of acceptance and use of technology (UTAUT) model on the intention and behavior of using e-Nabız application.

The population of the study consisted of general practitioners and specialist physicians actively working in any health facility in Turkey. Data were collected cross-sectionally from 236 physicians on a voluntary basis through a questionnaire. The response rate of data collection was calculated as 47.20%. Data were collected cross-sectionally from 236 physicians through a questionnaire. Descriptive statistics, correlation analysis and structural equation modeling were used to analyze the data.

The study found that performance expectancy, effort expectancy, trust and perceived privacy had a significant effect on physicians’ behavioral intentions to adopt the e-Nabız system. In addition, facilitating conditions and behavioral intention were determinants of usage behavior (p < 0.05). However, no significant relationship was found between social influence and behavioral intention (p > 0.05).

This study confirms that the UTAUT model provides an appropriate framework for predicting factors influencing physicians’ behaviors and intention to use e-Nabız. In addition, the empirical findings show that trust and perceived privacy, which are additionally considered in the model, are also influential.

The migration of physicians is a global interest, causing imbalances between developed and developing countries. Romania is one of Europe's major providers of physicians, not because there is a surplus, but because physicians are drawn to places with better living and working conditions. Medicine in Romania is increasingly highly advanced, and Romanian physicians are well appreciated all over the world. Despite being one of the countries with the most medical graduates in the world, Romania is suffering a doctor exodus. After joining the EU, the problem of physician migration became widespread, resulting in a deficient and inefficient healthcare system. Therefore, the purpose of this study is to estimate the losses registered by Romania because of physicians' decision to migrate.

These losses were calculated in two ways: utilizing the statistical life value and the amount of money invested in training a medical graduate.

According to the findings, the losses in 2018 were 104.16 million euros, approximately 0.12% of GDP.

The originality of this paper consists in data, being provided by the College of Physicians from Romania and the method used, this study being the only one that estimates the cost of Romanian physicians' migration. The paper adds to existing knowledge an empirical results regarding quantifying the value reflecting the departure of physicians, using value of statistical life and the amount of money invested in preparing a medical graduate.

This research paper aims to delve into the perceptions of health susceptibility among Iranian, Afghan and Tajik individuals hailing from asylum-seeking or refused asylum-seeking backgrounds currently residing in Finland, Norway and Sweden.

Semi-structured interviews were conducted between May and October 2022 involving a sample size of 27 participants. An adapted framework based on the health belief model along with previous studies served as a guide for formulating interview questions.

Notably influenced by cultural background, religious beliefs, psychological states and past traumatic experiences during migration journeys – before arrival in these countries till settling down – subjects’ perception of health concerns emerged significantly shaped. Additionally impacting perspectives were social standing, occupational status, personal/family medical history, lifestyle choices and dietary preferences nurtured over time, leading to varying degrees of influence upon individuals’ interpretation about their own wellness or illness.

Insights garnered throughout the authors’ analysis hold paramount significance when it comes to developing targeted strategies catering culturally sensitive health-care provisions, alongside framing policies better aligned with primary care services tailored explicitly around singular demands posed by these specific communities dwelling within respective territories.

This investigation represents one among few pioneering initiatives assessing perceptions regarding both physical and mental well-being within minority groups under examination across Nordic nations, unveiling complexities arising through intersecting factors like individual attributes mingling intricately with socio-cultural environments, thereby forming unique viewpoints towards health-care belief systems prevalent among such population segments.

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.

Various health systems are challenged by a multifaceted crisis of increased service demand and workforce shortages. The effects are devastating and may end up in decreased access to care, poor quality of patient care and extreme demands on the workforce. The introduction of the physician assistant (PA) profession provided an avenue to address such challenges in several countries. In Germany, the integration of PAs has been proceeding slowly.

To understand the integration of the profession in Germany, we conducted 15 expert interviews to reveal how the PA profession is perceived among healthcare experts as well as the barriers and facilitators of integration in inpatient care.

Our results highlight a generally positive perception of PAs, particularly in terms of workload relief and bridging the gap between healthcare professionals. Nonetheless, barriers include resistance from healthcare workers unfamiliar with the PA role, while workforce shortages and collaborative teamwork facilitate integration.

These findings lay the groundwork for potential integration-enhancing strategies in Germany.

Career burnout is prevalent in the PR industry, precisely when demand for professionals is increasing. While career burnout has been included in studies and theorising on professionalism and feminisation, issues with turnover and burnout remain.

Using a grounded theory approach, this qualitative study draws upon the lived experiences of 30 current and former female Australian PR professionals to gain an understanding of how they perceive signs of career burnout and the factors that contribute to it.

Career burnout is an occupational syndrome whereby someone gradually morphs from being highly motivated in their role to emotionally exhausted, cynical and/or experiencing feelings of failure. It is a protracted response to chronic workplace demands and stressors, and includes three dimensions: emotional exhaustion, depersonalisation and reduced personal accomplishment. It is specifically a workplace phenomenon, distinguished from anxiety and depression, which can emerge in any context.

A key contributor to career burnout were PR-specific workplace stressors that were perceived to stem from a lack of respect for, or understanding of, PR as a profession. The stressors included the need to‘prove the spend’of PR, unreasonable deadlines, clients disregarding advice or counsel, as well as broader societal perceptions of PR as ‘spin doctors’. This often led to the PR practitioner undertaking work that went against their own advice or resulted in unsuccessful organisational outcomes they felt could have been avoided had their advice been listened to and valued. The workplace factors contributing to burnout overlap in complex ways and the study supports the idea that burnout is a product of situational contexts, despite being acutely felt at the individual level.

This paper makes a conceptual contribution by intersecting two strands of literature (return to work following health issues and industrial relations) to facilitate our understanding of the potential role of social dialogue in supporting return to work (RTW) following the diagnosis of a chronic illness. It conceptualises the levels and channels through which various actors and their interactions may play a role in RTW facilitation within the actor-centred institutional framework.

The paper uses an exploratory design based mainly on desk research but is also informed by roundtable discussions done in six countries as part of a larger project.

The conceptual and analytical framework (CAF) is developed to explain how various actors interact together in ways shaped by the RTW policy framework and the industrial relations systems, resulting in a continuum of RTW facilitation situations.

There is limited research on return-to-work policies following diagnosis of chronic illness from a comprehensive actor-oriented perspective. The existing literature usually focusses on just one stakeholder, overlooking the role of social dialogue actors. By bridging the two streams of literature and incorporating all potential actors and their interactions in a unitary model, the proposed framework provides a valuable tool to further discuss how successful RTW after a diagnosis of chronic illness can be facilitated.

Teams across a wide range of contexts must look beyond task performance to consider the affective, cognitive and behavioral health of their members. Despite much interest in team health in practice, consideration of team health has remained scant from a research perspective. The purpose of this paper is to address these issues by advancing a definition and model of team health.

The authors review relevant literature on team stress, processes and emergent states to propose a definition and model of team health.

The authors advance a definition of team health, or the holistic, dynamic compilation of states that emerge and interact as a team resource to buffer stress. Further, the authors argue that team health improves outcomes at both the individual and team level by improving team members’ well-being and enhancing team effectiveness, respectively. In addition, the authors propose a framework integrating the job demands-resources model with the input-mediator-output-input model of teamwork to illustrate the behavioral drivers that promote team health, which buffers teams stress to maintain members’ well-being and team effectiveness.

This work answers calls from multidisciplinary industries for work that considers team health, providing implications for future research in this area.