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High-quality nursing home (NH) care has long been a challenge within the United States. For decades, policymakers at the state and federal levels have adopted and implemented regulations to target critical components of NH care outcomes. Simultaneously, our delivery system continues to change the role of NHs in patient care. For example, more acute patients are cared for in NHs, and the Center for Medicare and Medicaid Services (CMS) has implemented value payment programs targeting NH settings. As a part of these growing pressures from the broader healthcare delivery system, the culture-change movement has emerged among NHs over the past two decades, prompting NHs to embody more person-centered care as well as promote settings which resemble someone's home, as opposed to institutionalized healthcare settings.

Researchers have linked culture change to high-quality outcomes and the ability to adapt and respond to the ever-changing pressures brought on by changes in our regulatory and delivery system. Making enduring culture change within organizations has long been a challenge and focus in NHs. Despite research suggesting that culture-change initiatives that promote greater resident-centered care are associated with several desirable patient outcomes, their adoption and implementation by NHs are resource intensive, and research has shown that NHs with high percentages of low-income residents are especially challenged to adopt these initiatives.

This chapter takes a novel approach to examine factors that impact the adoption of culture-change initiatives by assessing knowledge management and the role of knowledge management activities in promoting the adoption of innovative care delivery models among under-resourced NHs throughout the United States. Using primary data from a survey of NH administrators, we conducted logistic regression models to assess the relationship between knowledge management and the adoption of a culture-change initiative as well as whether these relationships were moderated by leadership and staffing stability. Our study found that NHs were more likely to adopt a culture-change initiative when they had more robust knowledge management activities. Moreover, knowledge management activities were particularly effective at promoting adoption in NHs that struggle with leadership and nursing staff instability. Our findings support the notion that knowledge management activities can help NHs acquire and mobilize informational resources to support the adoption of care delivery innovations, thus highlighting opportunities to more effectively target efforts to stimulate the adoption and spread of these initiatives.

Healthcare is indispensable for any civilisation to attain a good quality of life and well-being on both mental and physical levels. The healthcare domain primarily falls under pharma, medical, biotechnology, and nursing. Also, other fields may be aligned with these primary fields. Healthcare amasses the contemporary trends and knowledge of upcoming techniques to improve healthcare processes. The practitioners are primarily doctors, nurses, specialists and health professionals, hospital administrators, and health insurance.

It is a fundamental attribute needed for any society to attain good quality of life and well-being in mental and physical health. It is a fundamental right of people to receive good healthcare where drug treatment and hospitalization are available at a nominal cost, as a requirement of today’s modern era. There appears to be a significant disparity in the availability of good healthcare in rural areas compared to urban in India. Even though we enter the digital era with the facilities offered in Industry 4.0 and other advanced technologies brings about a significant change of overall processing within healthcare systems. During the pandemic of COVID-19, there has been digital transformation with success globally. Healthcare cooperatives are a new norm to support the healthcare systems globally. The chapter discusses Gampaha healthcare cooperative and reviews Ayushman Sahakar scheme in India. The reforms require time to evolve.

School-level leaders should not be expected to be mired in emotional turmoil and sacrifice their own health, happiness and well-being to do their jobs effectively. While the emotional aspects of school-level leadership have continued to evolve and become increasingly complex since the turn of the twenty-first century, the supports available to these individuals remain outdated, ineffective, and moribund. If mentoring, anonymous telephone support lines and other ‘old school’ approaches for supporting school leaders were still effective, they would not be struggling to deal with the emotional aspects of their work and workload. Further, there is a need to provide ‘just-in-time’ supports that are available to school-level leaders when concerns arise. Absent structural changes, isolated and individualized approaches to self-care cannot mitigate the challenges principals face or the physical, mental and emotional toll associated with their work and workload. Communal strategies and policy levers are recommended in an effort to go beyond mindfulness and other (potentially) individualistic and neoliberal approaches to self-care. This chapter also explores how principal preparation programmes and other formal professional learning opportunities are an untapped resource in terms of strengthening school-level leaders' emotional regulation capacity and building a general appreciation for the emotional aspects of school-level leadership.

This chapter qualitatively explored the impact of including parent liaisons (i.e., parents with lived experience caring for a child with complex needs, who support other caregivers in navigating child and family needs) in a case conferencing model for children with complex medical/social needs. Case conferences are used to address fragmented care, shared decision-making, and set patient-centered goals. Seventeen semi-structured interviews were conducted with clinicians and parent liaisons to assess the involvement of parent liaisons in case conferencing. Two main themes included benefits of parent liaison involvement (10 subthemes) and challenges to parent liaison involvement (5 subthemes). Clinicians reported that liaison participation and support of patients reduced stress for clinicians as well as family members. Challenges to liaison involvement included clinical team/parent liaison communication delays, which were further exacerbated by the COVID-19 pandemic. Parent liaison involvement in case conferences is perceived to be beneficial to children with complex needs, their families, and the clinical team. Integration of liaisons ensures the familial perspective is included in clinical goal setting.

At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public health) and other industry sectors, began to recognize the limitations of the current fragmented healthcare system paradigm. Primary stakeholders, including employers, insurance companies, and healthcare professional organizations, also voiced dissatisfaction with unacceptable health outcomes and rising costs. Grand challenges and wicked problems threatened the viability of the health sector. American health systems responded with innovations and advances in healthcare delivery frameworks that encouraged shifts from intra- and inter-sector arrangements to multi-sector, lasting relationships that emphasized patient centrality along with long-term commitments to sustainability and accountability. This pathway, leading to a population health approach, also generated the need for transformative business models. The coproduction of health framework, with its emphasis on cross-sector alignments, nontraditional partner relationships, sustainable missions, and accountability capable of yielding return on investments, has emerged as a unique strategy for facing disruptive threats and challenges from nonhealth sector corporations. This chapter presents a coproduction of health framework, goals and criteria, examples of boundary spanning network alliance models, and operational (integrator, convener, aggregator) strategies. A comparison of important organizational science theories, including institutional theory, network/network analysis theory, and resource dependency theory, provides suggestions for future research directions necessary to validate the utility of the coproduction of health framework as a precursor for paradigm change.

This case study documents the move to emergency virtual learning at the University of Johannesburg. Prefacing promoting social justice and care, the authors explain how key challenges unique to a university in a developing world context were considered. The findings highlight the importance of agility, adaptability and the role of Ubuntu (i.e. values of compassion, solidarity and sharing) in higher education institutional leadership in a crisis. Furthermore, the authors highlight the need to address how structural inequality and poverty impact the pace of technological infusion in higher education in the Global South.

This chapter presents a research study that examined post-disaster authentic university academic care resilience (PAUACR) at a Historically Black College and University (HBCU). PAUACR is a university’s and its students’ capacity to bounce back from post-disaster educational challenges. PAUACR requires a strong caring response and authentic academic care environments. For the University of the Virgin Islands (UVI), PAUACR following Hurricanes Irma and Maria was crucial to ensure students successfully completed the academic year. To assess UVI’s PAUACR, this study utilized a caring about academic caregiving inventory (CAACI). This 49-item instrument was used to gain students’ discernment of post-disaster authentic university academic care (PAUAC). The research employed a cross-sectional exploratory survey research design. The empirical analysis found associations between the structural workings of UVI’s academic caregiving in the aftermath of hurricanes Irma and Maria. These findings offer distinctive indicators of UVI’s PAUACR. Along with the findings, this chapter offers practical lessons of academic resilience drawn from the experience of conducting post-disaster research.