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Lean Six Sigma in public and private healthcare organisations has received considerable attention over the last decade. Nevertheless, such process improvement methodologies are not generalizable, and their effective implementation relies on contextual variables. The purpose of this study is to explore the readiness of Italian hospitals for Lean Six Sigma and Quality Performance Improvement (LSS&QPI), with a focus on gender differences.

A survey comprising 441 healthcare professionals from public and private hospitals was conducted. Multivariate analysis of variance was used to determine the mean scores on the LSS&QPI dimensions based on hospital type, gender and their interaction.

The results showed that public healthcare professional are more aware of quality performance improvement initiatives than private healthcare professionals. Moreover, gender differences emerged according to the type of hospital, with higher awareness for men than women in public hospitals, whereas for private hospitals the opposite was true.

This study contributes to the Lean Six Sigma literature by focusing on the holistic assessment of LSS&QPI implementation.

This study informs healthcare managers about the revolution within healthcare organisations, especially public ones. Healthcare managers should spend time understanding Lean Six Sigma as a strategic orientation to promote the “lean hospital”, improving processes and fostering patient-centredness.

This is a preliminary study focussing on analysing inter-relationship between perceived importance of soft readiness factors such as gender dynamics as a missing jigsaw in the current literature. In addition, the research advances a holistic assessment of LSS&QPI, which sets it apart from the studies on single initiatives that have been documented to date.

This research paper aims to determine the factors needed to propose a platform where waqf (Islamic endowment) organizations can collaborate with government public hospitals to develop corporate waqf hospitals. Consequently, the elements of governance and sustainability are included in the management of corporate waqf hospitals thereby leading to the corporatization of public hospitals.

This study adopts the qualitative research methodology and undertakes content analysis of data collected from journal articles, magazines and official websites. Data analysis involves open coding with NVivo 12.

General findings from the literature review have shown that architectural and engineering fundamentals were essential factors in the success of past waqf hospitals of the era between 8th and 14th centuries. In that era, the decentralized waqf-based hospitals employed the mutawalli (the trustee/manager of the waqf assets) to govern the administration of the hospitals. Present corporate waqf hospitals can exploit the elements identified from past waqf-based hospitals and additionally adopt the private-public partnership model in the form of a muḍārabah (profit-sharing contract) agreement to design a sustainable waqf governance model for Malaysian public healthcare services.

The proposed platform is designed for a corporate waqf model developed in collaboration between Malaysian waqf institutions and public healthcare services. It abides by both the Malaysian fatwa (Islamic rulings) on waqf and the laws of the Malaysian Government.

There is potential for developing the Malaysian corporate waqf-governance healthcare model which will enable the hospital to provide better quality healthcare to more patients through upgrading the quality of equipment used in hospitals and/or better facilities at equal or lower costs. Consequently, this will not only improve waqf management and distribution but also result in reduction of government expenditure.

This research promotes the concept of a corporate waqf hospital which will provide innumerable beneficial healthcare services in terms of improved healthcare quality at affordable costs to the general public and at no cost to the poor and the underprivileged.

Although waqf has played an important role as a vehicle for Islamic financing in the society for centuries, a model of collaboration or partnership of waqf with public healthcare services has yet to be explored and developed. With proper corporate governance and well-managed sustainability in a corporate waqf model, this newly developed partnership between waqf institutions and public healthcare providers can be a first step in many more interesting collaborative arrangements that can be established between waqf institutions and public services in the future.

Our study investigates the role of the Human Resources Management (HRM) system strength in supporting Italian healthcare managers during times of uncertainty and change. The perceived HRM system strength and its relationship with managers’ taking charge behaviors, perceived procedural constraints, and work engagement were examined.

Two surveys were conducted to gather empirical data from a pooled sample of 121 healthcare managers located in hospitals across Italy. We use regression analysis to test our hypotheses.

The data show that strong HRM systems facilitate managers taking charge behaviors and work engagement. Additionally, the findings highlight the mitigating effect of a strong HRM system on procedural constraints, such as red tape, in public healthcare organizations.

Emphasizing the positive outcomes associated with strong HRM systems, the findings suggest that public health organizations should make efforts to put in place robust HR practices to bolster engagement and proactive behaviors among healthcare managers in times of uncertainty and change.

Analyzing a unique data set, the study extends the understanding of HRM system strength in the public sector, specifically in post-pandemic healthcare organizations. Overall, the study contributes to the growing literature on HRM system strength by offering novel insights into its nomological network.

The mass exodus of the professional healthcare workforce has become a cankerworm for a developing nation like Nigeria, and this worsens the already depleted healthcare systems in underdeveloped nation. This study investigated the rationale behind medical workers' brain-drain syndrome and the quality healthcare delivery in the Nigerian public healthcare sector.

To stimulate an understanding of the effect of the phenomenon called brain drain, the study adopted a diagnostic research design to survey the public healthcare personnel in government hospitals. The study administered a battery of adapted research scales of different measures to confirm the variables of interest of this study on a probability sampling strategy. The study surveyed 450 public healthcare sector employees from four government hospitals to gather pertinent data. The study used a structural equation model (SEM) and artificial neural networks (ANNs) to analyse the collected data from the medical personnel of government hospitals.

The findings of this study are significant as postulated. The study discovered that poor quality worklife experienced by Nigerian medical personnel was attributed to the brain-drain effect and poor healthcare delivery. The study further demonstrated that job dissatisfaction suffered among the public healthcare workforce forced the workforce to migrate to the international labour market, and this same factor is a reason for poor healthcare delivery. Lastly, the study discovered that inadequate remuneration and pay discouraged Nigerian professionals and allied healthcare workers from being productive and ultimately pushed them to the global market.

Practically, this study has shown three major elements that caused the mass movement of Nigerian healthcare personnel to other countries of the world and that seems novel given the peculiarity of the Nigerian labour market. The study is original and novel as much study has not been put forward in the public healthcare sector in Nigeria concerning this phenomenon.

The purpose of this paper is to review the causes of long waiting time in Hong Kong public hospitals and to suggest solutions in the service, organisational, systems, financial and policy perspectives.

The paper is a review of waiting time of public hospital services. Total joint replacement, which is one of the elective surgeries in public hospitals, is presented as a case study.

The average waiting time of semi-urgent and non-urgent patients in the accident and emergency departments of public hospitals is two hours, and that of specialist outpatient (SOP) clinics is from 1 to 144 weeks. For total joint replacement, it is from 36 to 110 months. Measures like Government subsidisation programme for the replacement surgery and employing adequate physiotherapists, Chinese medicine practitioners, clinical psychologists and nurses to reduce the waiting time are suggested. Issues concerning the healthcare system of Hong Kong, such as structural reform, service delivery model, primary care, quality and process management, and policy reviews, are also discussed.

The ‬over-reliance of public services has resulted in long waiting time in public hospitals in Hong Kong, particularly in the emergency services and SOP clinics. However, the consequences of long waiting period for surgical operations, though much less discussed by the media and public, can be potentially detrimental to the patients and families, and may result in more burdens to the already stretched public hospitals‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬.

Recently, the relationship between gender representation and organizational performance has been the focus of various studies. However, some research gaps still exist. First, in the healthcare sector, this relationship has been poorly explored. Moreover, in public management studies, researchers focusing on performance tend to focus exclusively on gender differences at the top and/or middle management level. This research aims at exploring the relationship between women's representation and performance in public hospitals at all organizational levels.

To achieve the research objective, 63 healthcare organisations were analysed through ordinary least squares regressions on panel data from 2012 to 2018.

Results show that, in the hospital setting, gender diversity and financial performance are related at every organizational level.

To the authors' knowledge, this is one of the first studies focusing on the link between gender and performance at every level of professional and employment category; avoiding focusing exclusively on top management, which was the case in previous studies on the topic. Moreover, it contributes to a poorly explored literature which is gender studies in public healthcare management.

Research was conducted to investigate whether, and how, political accountability might stabilise when agents are faced with profound changes in external structures such as competition laws and austerity policies.

We performed a field study from 2007 to 2015 in a regional hub in Finland and worked with data from document analysis, interviews and meeting observations. We have used embedded research design, where we apply methodological bracketing as well as composite sequence analysis for field research.

Accountability declined when irresistible external structures were the dominant influence on the unreflective actions of agents-in-focus. With time, however, the agents started acting critically by drawing on structures that could facilitate strategic actions to stabilise political accountability.

The field research and interpretation of the data were limited to the organisation analysed; however, the theoretical arguments allow for analytical generalisations.

The research demonstrates how public officials and political decision-makers can eventually adopt a strategic approach when faced with irresistible change in external structures.

The research demonstrates how public officials and political decision-makers can eventually adopt a strategic approach when faced with irresistible changes in external structures.

The study locates political accountability in the context of strong structuration theory and discusses how it is redefined by external structures.

This study investigates the effect of user fees on access and waiting time in Nigeria. For access, the effect of user fees on both preventive and curative care; and the effect of user fees on waiting time at public healthcare facilities were examined. User fees are vital for the fiscal sustainability of healthcare provision for most African economies. Its imposition could debar healthcare access by the poor while its removal can reduce quality of care and induce longer waiting time.

The wave 3 of the Nigerian General Household Survey (2015/16) data was used for users of public health facilities. Access to healthcare was modelled using utilization data in a logistic regression model while waiting time was through the Negative Binomial Regression Model (NBRM).

The analyses showed significant effects of user fees on access to both preventive and curative care and on time spent waiting to make use of healthcare services. Individuals were able to access healthcare services regardless of amounts paid. Also, there was a non-negative effect of user fee imposition on waiting time.

Nigeria should improve healthcare facilities to address the enormous demand for healthcare services when designing policy for health sector.

This paper shows that even with the imposition of user fees, healthcare facilities could still not cater for the rising healthcare needs of the populace but cautioned that its abolition may not be a preferred option.

This case study paper aims to explore the complexities and challenges of epidemic response and public health surveillance in Native American and Indigenous American communities in the United States and find viable solutions. This paper explores these topics through the emergence and impact of the hantavirus pulmonary syndrome (HPS) within the Navajo Nation in the United States using critical incident analysis and best practices.

This project is a case study paper based on a topical review of the literature. A topical review of the literature is a comprehensive exploration of the current body of knowledge within a particular research field. It is an important tool used by scholars and practitioners to further the development of existing knowledge as well as to identify potential directions for future research (Fourie, 2020). Such a paper can provide a useful insight into the various aspects of the process that the researcher may have overlooked, as well as highlighting potential areas of improvement (Gall et al., 2020). It can also provide a useful source of ideas and inspiration for the researcher as it can provide an overview of the various approaches used by other researchers in the field (Göpferich, 2009). Case study papers using a topical review of the literature have been used to help frame and inform research topics, problems and best practices for some time. They are typically used to explore a topic in greater depth and to provide an overview of the literature to improve the world of practice to provide a foundation for future comprehensive empirical research. Case study papers can provide research value by helping to identify gaps in the literature and by providing a general direction for further research. They can also be used to provide a starting point for research questions and hypotheses and to help identify potential areas of inquiry.

This study explores best practices in public health surveillance and epidemic response that can help strengthen public health infrastructure by informing the development of effective surveillance systems and emergency response plans, as well as improving data collection and analysis capabilities within Native American and Indigenous American communities in the United States that also have the option to include new technologies like artificial intelligence (AI) with similar outbreaks in the future.

The literature review did not include any primary data collection, so the existing available research may have limited the findings. The scope of the study was limited to published literature, which may not have reported all relevant findings. For example, unpublished studies, field studies and industry reports may have provided additional insights not included in the literature review. This research has significant value based on the limited amount of studies on how infectious diseases can severely impact Native American communities in the United States, leading to unnecessary and preventable suffering and death. As a result, research on viable best practices is needed on the best practices in public health surveillance and epidemic response in Native American and Indigenous American communities through historical events and critical incident analysis.

Research on public health surveillance and epidemic response in Native American communities can provide insights into the challenges faced by these communities and help identify potential solutions to improve their capacity to detect, respond to and prevent infectious diseases using innovative approaches and new technologies like AI.

More research on public health surveillance and epidemic response can inform policies and interventions to improve access to healthcare for Native American populations, such as increasing availability of healthcare services, providing culturally appropriate health education and improving communication between providers and patients. By providing better public health surveillance and response capacity, research can help reduce the burden of infectious diseases in Native American communities and ultimately lead to improved public health outcomes.

A local healthcare organisation providing healthcare to 288,000 residents in Sweden struggled with a longstanding budget deficit. Several attempts to overcome the demanding financial situation have failed. A decommissioning programme was launched, and two years later, an evaluation indicated positive outcomes. The aim of this study was to explore factors politicians and public servants perceived as enablers to the successful implementation of the programme.

A deductive content analysis approach using a framework of factors facilitating successful implementation of decommissioning decisions was applied to analyse interviews with 18 informants.

Important factors were: (1) a review report contributing to the clarity of evidence, which (2) made the clarity of the rationale for change undeniable and (3) strengthened the political support for change. Additional factors were: (4) the strength of executive leadership, (5) the strength of clinical leadership supported by (6) the quality of project management and (7) a cultural and behavioural change seen as an important outcome for the path forward. A way to maximise the potential for a successful implementation of a large-scale decommissioning programme is to build a shared vision and a collaboration grounded in convincing evidence. Include public servants with a clinical background in the executive leadership team to contribute with legitimacy, competence, and trust in the decommissioning programme’s intention.

The paper addresses the limited knowledge of best practices in decommissioning processes and contributes empirical knowledge from a successful case.