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Goffman’s (1961) work on total institutions has been relatively neglected in the fields of organizational research. This paper compares the conceptions of obedience to authority in two different types of voluntary total institutions and how such conceptions affect interaction contrary to the aims of the organizations. Consequently, by addressing how conceptions of authority and constructions of the obedient self shape conditions for underlife, the analysis provides knowledge about the variety of ways in which total institutional authority works and contributes to the understanding of the mechanisms of organizational underlife.

This work aims to integrate the concepts generated by a systematic literature review on patient flows in emergency departments (ED) to serve as a basis for developing a generic process model for ED.

A systematic literature review was conducted using PRISMA guidelines, considering Lean Healthcare interventions describing ED patients’ flows. The initial search found 141 articles and 18 were included in the systematic analysis. The literature analysis served as the basis for developing a generic process model for ED.

ED processes have been represented using different notations, such as value stream mapping and workflows. The main alternatives for starting events are arrival by ambulance or walk-in. The Manchester Triage Scale (MTS) was the most common protocol referred to in the literature. The most common end events are admission to a hospital, transfer to other facilities or admission to an ambulatory care system. The literature analysis allowed the development of a generic process model for emergency departments. Nevertheless, considering that several factors influence the process of an emergency department, such as pathologies, infrastructure, available teams and local regulations, modelling alternatives and challenges in each step of the process should be analysed according to the local context.

A generic business process model was developed using BPMN that can be used by practitioners and researchers to reduce the effort in the initial stages of design or improvement projects. Moreover, it’s a first step toward the development of generalizable and replicable solutions for emergency departments.

Drawing on interviews with two types of essential workers – wound clinicians and care workers – the chapter examines stigma management in dirty care work through the lens of emotion management. The study combines two dimensions of dirty work: physical taint in relation to bodywork and social taint linked to working in close proximity to socially stigmatized clients. Hence, stigma management extends to dealing with the physically and socially dirty features of essential care work. In addition, the authors’ assessment of social stigma includes how essential care workers also sought to alleviate the social stigma encountered by their clients. In so doing, the authors extend the literature on dirty work to identify how emotion management skills are central to the stigma management strategies of the essential care workers in this study. The authors demonstrate how both groups deal with their stigma by emphasizing the emotion management skills in ‘doing’ dirty work and in the ‘purpose’ of this work, which includes acknowledging how the authors attempt to address the social taint encountered by their clients. Additionally, by comparing two occupations with different contexts and conditions of work, the authors show how complex emotion management skills are gendered in care work to expand the understanding of gender and stigma management. Furthermore, these emotion management skills emanate from the deep relational work with clients rather than through occupational communities. The authors argue that by focussing on emotion management, the hidden skills of dirty work in gendered care work are illuminated and contribute to contemporary debates about whether stigma can be overcome.

Coronavirus disease (COVID-19) has challenged leadership in hospitals worldwide. The experiences of leadership during the pandemic changed leadership significantly. This study aims to describe nurse leaders’ perceptions of what future leadership in hospital settings in the post-pandemic era needs to be like.

A qualitative descriptive study was used. A total of 20 nurse leaders from the Finnish central hospital were interviewed from June to October 2021. The data were analysed using inductive content analysis.

The analysis revealed five main categories describing nurse leaders’ perceptions of future leadership in hospital settings in the post-pandemic era: digitalisation and hybrid working culture, development of sustainable working conditions, moving smoothly to the post-pandemic era, dissolution of traditional regimes of organisation and flexibility in leadership.

In the post-pandemic era, the constantly changing demands and challenges currently facing healthcare systems have significantly increased the complexity of hospital organisations. This requires critical evaluation and change to traditional leadership. Enhancing flexibility and authenticity in leadership, strengthening competencies, implementing a wide range of digital resources and increasing the appeal of the nursing profession to build the next generation of nurses – all of these are needed to provide sustainability in future healthcare.

The results identify the critical points of leadership that need to be developed for future challenges and for maintaining a sufficient supply of qualified professionals. Acting on this information will enhance flexibility in organisations and lead to acceleration of changes and the development of new kinds of leadership in the future

User diversity has been discussed in many fields of study for decades. Nevertheless, some cohorts are rarely included in mainstream research. According to the concept of universal design of research (UDR), people with disabilities should be more often included in participant pools. There is, however, a need for certain methodological considerations to achieve UDR.

The suggested guidelines are based upon existing guidelines and research in addition to key takeaways from studies conducted by the authors over the past 15 years. Six studies are used to show how the guidelines can be applied in research involving three example cohorts, namely people with dyslexia, aphasia and intellectual disability.

Extensive guidelines are needed to increase user inclusion in mainstream studies and support researchers in conducting purposeful and ethical research. The suggested guidelines should be examined for other cohorts to ensure that all types of user needs are accommodated.

This study contributes with methodological approaches to enhance inclusion of all types of participants in mainstream research.

The main contribution is The seven principles of UDR, a further development of the original principles for UDR.

This paper aims to strengthen the connection between therapeutic built environments and tourism research and practice. While there is evidence in the importance of the Built Environment (BE) of cities, workspaces and health-care facilities to health, the BE of facilities for tourism in relation to health remains relatively unexplored.

The paper conducts an exploratory search on architecture and tourism BE and narrowed it down to a scoping review on wellness tourism and architectural health impacts from 2010 to 2024. This would highlight lessons learned from the field of medical architecture, i.e. a cross-disciplinary field combining BE research, public health and health-care services research, to explore potential synergies of cross-pollination with the field of hospitality and medical architecture.

Principles and theories of medical architecture can be incorporated into the BE of wellness hospitality, tourism for ageing and pandemic preparedness.

The paper sets the basis of a novel cross-disciplinary collaboration between therapeutic architecture and hospitality for increasing the societal impact of the latter. This is particularly important in a post-Covid and an ageing society.

本文旨在加强治疗性建筑环境与旅游研究和实践之间的联系。虽然有证据表明城市、工作场所和医疗设施的建筑环境(BE)对健康很重要, 但与健康相关的旅游设施的建筑环境仍相对未被探索。

作者对建筑和旅游建筑环境进行了探索性搜索, 并将其缩小到2010年至2024年期间的健康旅游和建筑健康影响的范围审查。这将突出医疗建筑领域的经验教训, 即结合建筑环境研究、公共卫生和医疗服务研究的跨学科领域, 以探索与酒店业和医疗建筑领域交叉授粉的潜在协同效应。

医疗建筑的原则和理论可以纳入健康酒店业、老龄化旅游和大流行病准备的建筑环境中。

我们为治疗性建筑和酒店业之间的新型跨学科合作奠定了基础, 以增加后者的社会影响。这在后疫情时代和老龄化社会中尤为重要。

Este documento pretende reforzar la conexión entre los entornos construidos terapéuticos y la investigación y la práctica del turismo. Aunque existen pruebas de la importancia del entorno construido (EC) de las ciudades, los espacios de trabajo y las instalaciones sanitarias para la salud, el EC de las instalaciones para el turismo en relación con la salud sigue estando relativamente inexplorado.

Realizamos una búsqueda exploratoria sobre arquitectura y el EC turístico y la acotamos a una revisión de alcance sobre el turismo de bienestar y los impactos arquitectónicos en la salud desde 2010 hasta 2024. Esto pondría de relieve las lecciones aprendidas en el campo de la arquitectura médica, es decir, un campo interdisciplinar que combina la investigación de la EC, la salud pública y la investigación de los servicios sanitarios, para explorar posibles sinergias de polinización cruzada con el campo de la hostelería y la arquitectura médica.

Los principios y teorías de la arquitectura médica pueden incorporarse a la EC de la hosteleria para el bienestar, el turismo para el envejecimiento y la preparación ante pandemias.

Sentamos las bases de una novedosa colaboración interdisciplinar entre la arquitectura terapéutica y la hostelería para aumentar el impacto social de esta última. Esto es especialmente importante después de la crisis y en una sociedad que envejece.

There is evidence that both hypnotherapy and virtual reality (VR) can be helpful in reducing perceived stress in the general population. This is a feasibility and acceptability trial of an intervention combining hypnotherapy and VR to establish its acceptability in students. This study aims to establish whether students found the experience acceptable, described any adverse effects and whether they reported feeling calmer after the experience.

The study was testing the hypothesis that students would attend the sessions and find the experience acceptable. A secondary hypothesis was that preliminary qualitative and quantitative evaluation of measures of stress and wellbeing would signal potential improvements.

All participants completed all three sessions. No side effects were reported. Visual analogue scales recorded each day assessing the immediate effect improved. At the end of the intervention, there was an increase in wellbeing of 2.40 (95% CI: 1.33, 3.53, p = 0.006), and a decrease in depression of 0.73 (95% CI: 0.40, 1.07, p = 0.010), reflecting large effect sizes of 0.76 and 0.83, respectively. Qualitative feedback was generally very positive.

This study is small with just 15 students and was over a short period of time. The recruitment method meant there was no way to establish whether the volunteer students were representative of the general student population in terms of mental wellbeing. There was no control arm.

The preliminary results suggest that a larger controlled trial is justified.

This VR experience may have benefit to university students and to the wider population.

This described the evaluation of a novel intervention for perceived stress combining hypnotherapy and virtual reality in a group of healthcare students, with promising results suggesting further evaluation is needed.

Ageing is associated with multi-morbidity, polypharmacy and medication-related harm (MRH). There is limited published literature on MRH in older Egyptian adults. This study aims to determine the incidence and risk factors associated with MRH in an Egyptian cohort of older patients in the 8-weeks period after hospital discharge.

This study recruited 400 Egyptian patients, aged = ≥ 60 years from 3 hospitals in Cairo and followed them up 8 weeks after discharge using a semi-structured telephone interview to verify MRH events (type, probability, severity and preventability) and related factors.

The participants’ ages ranged from 60 to 95 years with 53% females. In the final cohort of 325 patients analyzed, MRH occurred in 99 patients (incidence of 30.5%), of which 26 MRH cases (26.2%) were probable, serious and preventable. MRH included adverse drug reactions (ADRs), non-adherence and medication errors. Multivariate regression analysis showed that non-adherence and inappropriate prescription had highly significant association with MRH (P < 0.001), history of previous ADR, living alone and presence of paid caregiver had significant association (P 0.008, 0.012, 0.02 respectively), while age, medications number, length of stay (LOS) and cognitive impairment were not significantly associated with MRH.

These findings demonstrate the magnitude of MRH in Egypt affecting almost a third of older adults after leaving the hospital. These original data could guide decision-makers to enhance older patients’ medication safety through education, quality improvement and policy.

MRH in Egyptian older adults post-hospital discharge has not been adequately reported in scientific literature.

The purpose of this mixed-methods study was to explore how medical secretaries experience digital transformation in a Swedish healthcare organisation, with a focus on workplace climate and health.

Data were collected using a sequential exploratory mixed-methods design based on grounded theory, with qualitative data collection (a Quality Café and individual interviews) followed by quantitative data collection (a questionnaire).

Four categories with seven underlying factors were identified, emphasising the crucial need for effective organisation of digital transformation. This is vital due to the increased knowledge and skills in utilising technology. The evolving roles and responsibilities of medical secretaries in dynamic healthcare settings should be clearly defined and acknowledged, highlighting the importance of professionality. Ensuring proper training for medical secretaries and other occupations in emerging techniques is crucial, emphasising equal value and knowledge across each role. Associations were found between some factors and the health of medical secretaries.

This study adds to the knowledge on digital transformation in healthcare by examining an important occupation. Most data were collected online, which may be a limitation of this study.

Several aspects of the medical secretaries’ experiences were identified. Knowledge of these is valuable for healthcare managers to make digital transformation more effective while avoiding excessive strain on medical secretaries.

Medical secretaries are expected to contribute to the digitalisation of healthcare. However, minimal research has been conducted on the role of medical secretaries in workplace digitalisation, focusing on workplace roles and its dynamics.

This paper aims to deepen the knowledge of consumer wellness by conceptualizing this construct in an everyday retail setting, specifically a health food store. With wellness seeking being a central theme in the positioning strategy of many food retail stores, this study aims to investigate the development of an everyday wellness pursuit in a retail setting, identify its underlying dimensions in a health food store setting and establish the key managerial drivers that nurture it in such context, from the consumer standpoint.

The research design uses a qualitative approach. In-depth interviews with 20 customers of six multibranch health food retailers were carried out.

The findings show the holistic and multidimensional nature of wellness in an everyday consumption setting and highlight the development of physical, emotional, intellectual, social and spiritual consumer wellness in this context. They also bring to light how, in an everyday activity such as a health food retail store visit, retailers can co-create and nurture consumer wellness through their product assortment, store environment and employees’ orientation toward customer wellness.

The main contribution of this study lies in the conceptualization of the retail wellnesscape, defined as a retail space that consumers choose to visit in their daily lives that contribute to their holistic wellness journey. This paper emphasizes both the importance and the feasibility of cultivating consumer wellness on an everyday basis, for both consumers and retailers, while it has traditionally been associated with more occasional and out of the ordinary settings such as wellness tourism.