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This study explores the awareness (AWN) levels of good governance amongst Thai credit union cooperatives' (CUCs) members and the factors hindering good governance practice in Thai CUCs.

This study used a survey questionnaire from 629 members of 36 selected CUCs in Thailand. This study analysed the determinants of governance AWN levels of Thai CUCs' members using the ordered probit model. The study also employs OLS estimation to investigate the factors hindering good governance practices.

The study shows that members of different CUC types and sizes have different levels of governance AWN. Members' characteristics, experiences, and perceptions significantly influence CUC members' AWN of governance issues. The findings also suggest that a lack of morality, transparency, participation, responsibility and accountability are key obstacles that hinder good governance practices of Thai CUCs.

This is the first study that attempts to assess the level of AWN amongst Thai CUCs' members in different CUC sizes and types. This is also the first research that identifies the factors that hinder good governance practice in Thai CUCs based on members' evaluations. The study's findings provide important reference and implications for Thai policy makers and CUCs' board of managers to enhance members' AWN and CUCs' governance performance, and thus increase income and living standard of CUCs' members in the long term.

This study aims to summarize studies that compared the performance of health-care institutions led by leaders with medical background versus those with no medical background.

A systematic search was conducted on three databases: PubMed, Ovid Medline and Google Scholar to identify relevant peer-reviewed studies using the keywords “performance,” “impact,” “physician,” “medical,” “doctor,” “leader,” “healthcare institutions” and “hospital.” Only quantitative studies that compared the performance of health-care institutions led by leaders with medical background versus non-medical background were included. Articles were screened and assessed for eligibility before the relevant data were extracted to summarize, appraise and make a narrative account of the findings.

A total of eight studies were included, four were based in the USA, two in the UK and one from Germany and one from the Arab World. Half of the studies (n = 4) reported overall better health-care institutional performance in terms of hospital quality ranking such as clinical effectiveness and patient safety under leaders with medical background, whereas one study showed poorer performance. The remaining studies reported mixed results among the different performance indicators, especially financial performance.

While medical background leaders may have an edge in clinical competence to manage health-care institutions, it will be beneficial to equip them with essential management skills to optimize leadership competence and enhance organizational performance.

The exclusive inclusion of quantitative empirical studies that compared health-care institutional performance medical and non-medical leaders provides a clearer link between the relationship between health-care institutional performance and the leaders’ background.

The issue of energy efficiency is becoming increasingly prevalent globally due to factors such as the expansion of the population, economic growth and excessive consumption that is not sustainable in the long run. Additionally, healthcare facilities and hospitals are facing challenges as their operational costs continue to rise. The research aim is to develop strategic frameworks for managing green hospitals, towards energy efficiency and corporate governance in hospitals and healthcare facilities.

This research employs a qualitative case study approach, with a sample of ten hospitals examined through interviews with senior management, executives and healthcare facilities managers. Relevant data was also collected from literature and analysed through critical appraisal and content analysis. The research methodology is based on the use of grounded theory research methodologies to build theories from case studies.

The research developed three integrated conceptual strategic frameworks for managing hospitals and healthcare facilities towards energy efficiency, green hospital initiatives and corporate governance. The research also outlined the concepts of green hospitals and energy efficiency management systems and best practices based on the conclusions drawn from the investigated case studies.

The study is limited to the initiatives and experiences of the healthcare facilities studied in the Middle East and North Africa (MENA) region.

The research findings, conclusions, recommendations and proposed frameworks and concepts contribute significantly to the existing body of knowledge. This research also provides recommendations for hospital managers and policymakers on how to effectively implement and manage energy efficiency initiatives in healthcare facilities.

The performance governance model, based on the use of performance information to improve governance, is particularly complex, considering the inter-institutional relationships and community involvement that it requires. In order to contribute to the scientific debate on this model, the paper aims to highlight what are the challenges in developing three variables of performance governance (operational performance measurement tools, governance integration and citizen involvement) in the public health context.

Based on the previous literature, we identified three variables that characterize the performance governance model. We then explored them through the case study methodology applied to the Apulia Regional Health System.

The analysis allows us to conclude that the healthcare system under consideration is still far from applying the performance governance model, but it highlights some factors that are preparatory to the same. Moreover, starting from the empirical evidence, some considerations arise regarding managerial and policy making implications for the variables investigated.

The paper contributes to a growing body of critical literature on performance governance contextualizing the analysis in a particularly relevant area of the public sector, namely public health. Furthermore, the research also identifies some potential risks of the performance governance model (rigidity in performance measurement tool, organization-objective-responsibility relationship, participatory illusion).

Hospital governance accountability structures in Iran, similar to other countries, have undergone various reforms with different goals. The current study aimed to identify the rules and regulations of the hospital governance structure in Iran and how they pay attention to accountability.

This qualitative document content analysis study was conducted using hospital governance structure documents in Iran using the Ready materials, Extract data, Analyze data and Distil (READ) document analysis framework. 2,921 documents were extracted from the official government websites of Iran. After screening, seven documents related to the hospital governance structure were selected. A directed content analysis approach was used. The findings were finally future purification matched with the original documents.

The findings showed that documents had not addressed the inclusive governance structure of the hospital comprehensively. The medical staff organization structure is not considered in the documents, and its duties are assigned to a technical or a clinical director. Most documents addressed financial accountability. The documents did not require the hospital’s governance to have an inclusive accountability structure. However, they paid more attention to the administrative and financial autonomy of hospitals.

Accountability is one of the most essential components in the hospital's governance structure. It can increase the success of hospital efficiency, effectiveness, vision and mission fulfillment. The study result can help health services policymakers and managers formulate better organization structure rules and regulations for hospital governance accountability.

This study is the first qualitative analysis of accountable governance structure documents in Iranian hospitals. We used the READ method as a comprehensive approach for document analysis.

According to Global Healthcare Security Index 2021, India ranked 66 out of 195 countries, indicating the need and scope for improvement. The Cooperative healthcare system which has been rendering exemplary services is yet to gain visible recognition in India. Given the need for upgrading the health infrastructure in India and providing more affordable health services to the country’s growing population, it would help appreciate the large role that cooperative healthcare can play along with others. This study explores the structure, conduct, and performance of healthcare co-operatives in India, the factors contributing to their success and failure, and the challenges they face. The Health Cooperatives have a strong presence in Kerala and Karnataka and are also coming up in other parts of the country. However, a detailed database of them for public awareness is very limited. The cooperative hospitals can meet the basic requirements of curative treatment in rural and poorly-endowed urban areas. The democratic way in which they function makes them a destination for a financially weaker section. They must retain this feature. The study covers two successful cases which reveal that India needs a more dense healthcare cooperative network. Since cooperative hospitals in tune with the spirit of service run on the principle of being ‘Not-for-Profit’ they need to be supported by the governments more liberally, without however interfering with their governance and administration.

The purpose of this paper is twofold. First, it identifies whether sustainability reporting has become an institutionalized cultural norm in the daily routines and organizational practices of Spanish public hospitals. Second, it finds out why sustainability reporting has become (or not) an institutionalized norm in the Spanish public hospital field.

To accomplish the research aims, the authors have adopted a qualitative method approach by combining two main data sources: (1) a documentary analysis of reports published by 60 Spanish public hospitals that consistently maintained their commitment to this activity over the past 10 years; and (2) a semi-structured interview with seven hospital managers and with seven participants from professional organizations.

The authors have found that sustainability reporting has not become an institutionalized practice in the Spanish public hospital setting. Based on the notion of normativity, the findings indicate that the institutional conditions that support the emergence of a norm are not met (Bebbington et al., 2012). In particular, the lack of a coherent normative framework, the absence of congruence with previous similar practices and the lack of clarity in the norm explain why a reporting norm has not emerged. Currently, the societal context has not developed an appropriate discourse around the development of sustainability reporting in the Spanish public sector.

The contribution of this research is double: (1) From a practical level, this paper contributes to the accounting literature by analyzing the development of sustainability reporting practices in the public sector; (2) According to the notion of normativity, the novelty of this paper is to explore whether a sustainability reporting norm emerges in Spanish public hospitals.

Providing public healthcare to people is a major challenge for governments. In this sector, public-funded systems are grossly inadequate in India, and excessive commercialization and exploitation by the private sector are a stark reality. The cooperative healthcare model is emerging as an alternate system in Kerala with its strong service objective to challenge the woes of private healthcare. The cooperative hospitals in the state worked round the clock to serve the poor and needy during the devastating COVID-19 pandemic. The pandemic has also badly exposed the weakness of our healthcare system in the wake of challenges posed by an increase in demand for health services, especially in rural areas. The resultant rise in the cost of treatment has put severe strains on the people at a time when even their day to day jobs were in peril. India has a strong cooperative movement and world-class institutions to serve as models in each sector. The Thrikkakara Municipal Co-operative Hospital, located at Cochin in the Kerala State of India on which this case study is written was established by the Hospital Society Ltd. in 1999, as a project under the People’s Planning Programme of the Government. Today, it has grown into a medium-sized healthcare establishment with the prime objective ‘Modern healthcare to all at affordable costs’ and cater to an average of 700 outpatients a day. This case study reveals the inception, development over years, facilities available, operations, management, public interface, and outlook for the hospital to become a modern healthcare institution to serve the people still better.

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.

This paper aims to examine lean thinking in medical commodities supply chains by considering its applications and success factors. It determines the drivers and wastes of medical commodity supply chain, and the existing lean tools and practices together with their application in the supply chain processes. The paper also examined the challenges and success factors for effective lean application in the medical commodities supply chains.

The study used qualitative approaches, in-depth interviews and focus group discussions with key informants to form the basis for data collection. Through thematic analysis, the collected data were analyzed by developing themes reflecting the objectives of the study.

The main drivers for waste associated with the supply chain were demand management, supplier development, institutional framework and governance. The wastes were observed at the level of inventory, operation costs, transaction costs, delays in terms of service, commodity delivery time and quality. Digitalization, information technology and standardization were the tools for medical supply chain. Poor infrastructure, unreliable internet supply, environmental uncertainty and poor management support were challenges to realizing an effective supply chain.

Although the qualitative approach used in the study provides detailed information, a quantitative study covers a larger sample for generalization.

Capacity building and professionalism should be given a priority because the philosophy of lean focuses on waste removal and continuous improvement, which highly depends on the quality of human resource (Brito et al., 2020). Limited human resource capabilities in supply chain management will, therefore, result into poor operational efficiency, which are wasted. Moreover, systems interoperability is key waste minimization and, therefore, demands interventions.

The government under the Ministry of Health and other key sector ministries such as local and regional governments should better understand the role of the waste drivers and adopt system-wide reforms to support improvements to remove waste in the medical supply chain. For example, the current institutional framework creates an administrative block and hence leads to wastes. This bureaucratic procedure should be removed to minimize wastes along the chain.

This study is among the first studies to determine applicability and implementation of lean in a resource-constrained context. The paper identifies contextual factors for lean implementation. This paper focused on a holistic view of the entire supply chains to enhance a well-functioning supply chain in delivering health commodities.