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This article expands literature on user innovation by exploring the mechanisms that support user innovations in the context of a public organisation. Research has hitherto documented support mechanisms for user innovation in producer companies, where users contribute in early or temporary innovation phases as external non-employees or lead-users engaged by the producer. Complementarily, this paper explores a lesser known area of support mechanisms, those that support internal user innovations in a public sector setting.

Employing a qualitative study of a Norwegian public hospital at the interface between users (personnel and patients) and organisational support (facilitators who orchestrate user innovations), this article analyses in-house user innovation based on observations, text documentation and interviews over a four-year period.

In this public hospital, holistic organisational facilitation of “public user innovators” formed the key support mechanism built on “people” (facilitating co-creation), “process” (facilitating ideas, project realisation and implementation) and “coordination” (facilitating systems and communication). The findings show that public and producer organisational mechanisms both resemble and differ in many respects, as illustrated by the framework developed to describe these characteristics, such as that producers insource users, while the public organisation outsources production.

The originality of the article lies in the identification and description of “public user innovation”, a new term developed from this study of a public organisation in contrast to the dominant literature on producer companies. This article contributes new insights by differentiating the roles of user innovators and the mechanisms that support such innovations. New implications are drawn from the public side of organisational support in user innovation research.

In recent decades, human resource management (HRM) in health organizations has faced several problems associated with employees' efficiency and happiness, which has been particularly exacerbated after the pandemic crisis. In this scenario, this study seeks to analyze nurses' turnover intention by comparing Portuguese public and private healthcare organizations. As determining factors, transformational leadership, perceived organizational support and organizational commitment were considered.

A survey was digitally applied to 277 nurses from Portuguese public and private healthcare organizations.

Results suggested that there are differences in nurses' turnover intentions: there is a greater likelihood of nurses in the private sector planning to leave the healthcare organizations the nurses work for when compared to public hospital nurses. Furthermore, nurses in public hospitals perceive lower levels of transformational leadership, organizational support and organizational commitment than those in the private sector. The underlying cause as to the intention of leaving the public sector resides in normative commitment. On the other hand, lower affective commitment explains the intention to abandon the private sector.

This study is relevant for human resource managers and administrators in public and private hospitals since it enables a diagnosis of the situation, as well as a definition of the most appropriate policies for each of the sectors as a strategy to attract and retain health professionals.

This study is significant as the study provides a better understanding of the reasons which lead nurses to consider leaving the organization where the nurses work and the difference between nursing professionals in public and private hospitals.

This study aims to validate a model to assess the level of lean maturity of Brazilian hospitals based on the adaptation of the SAE J4000/2021 standard.

The methodology was divided: (1) adaptation of the standard to the health context, (2) application of the questionnaire through a survey, and (3) comparison of the results of the level of maturity in the standard and by the clustering technique, using Minitab.

The research presents two contributions: (1) validation of a model to assess the level of lean maturity based on the SAE J4000/2021; (2) insights into the level of maturity of Brazilian hospitals. It was observed that only 10% of the sample was classified at maturity level 3 and 75% at level 2. Private and large hospitals showed greater maturity compared to the others.

This includes the limited number of hospitals that participated in the survey, given the difficulty of adherence to due constraints of time and staffing from hospitals, during the COVID-19 pandemic.

This article presents a lean maturity assessment proposal, adapting a consolidated standard in the automobile industry to the health context. Insights on the lean maturity of Brazilian hospitals can contribute to the development of policies to encourage the implementation of the lean philosophy directed to each specific environment.

This study serves as a guide for public agents interested in monitoring the quality of hospital indicators through the SAE J4000/2021 standard. From this lean maturity analysis, hospital managers can understand their opportunities for improvement in both human and organizational aspects. This favors the improvement of service delivery to society that depends on health services.

Due to the lack of research that validates lean maturity level assessment models in Brazilian hospitals, this study can be considered a pioneer in this Brazilian research by validating the SAE J4000/2021 standard in its updated version in the health context.

The study investigates the relationship between hospital environmental factors and the well-being of geriatric in-patients. It aims to identify the impact of architectural design on comfort, safety, privacy and stress levels experienced by elderly patients during their hospital stays.

Employing a mixed-methods approach, the research assesses the experiences of 100 geriatric in-patients across various hospital types through surveys, observational checklists and state anxiety measurements. The methodology involves examining architectural features, patient perceptions and correlations among environmental variables and patient experiences. Statistical analyses, including correlations and chi-square tests, were employed to discern associations between environmental variables and patient experiences.

The research identified key architectural features significantly impacting geriatric patients' experiences. Factors such as sturdy beds, furniture quantity, lighting conditions, proximity to facilities and ward occupancy levels were found to influence spatial, sensory and social comfort. Notably, proximity to facilities and control over the immediate environment were crucial for self-control and safety perceptions. Privacy, highly valued by patients, correlated with the presence of curtains and ward occupancy. Moreover, patient stress levels exhibited correlations with autonomy, privacy and ward occupancy.

This research offers significant insights into the criticality of specific architectural elements in enhancing comfort and reducing stress for geriatric in-patients. These findings hold substantial value for healthcare facility design, emphasizing the need to prioritize certain design aspects to promote the well-being of elderly patients during hospitalization.

The study aims to have adults discuss experiences, practices needs and feelings related to health management, diet and food security.

A total of 22 immigrants were recruited from the Open School of Immigrants in Piraeus, Attica, Greece, to participate in focus group discussions. The discussions were audio recorded and thematically analyzed. Three major themes were developed: pathways to health care, nutrition management and experiences related to food shortages.

Most of the participants identified internet as the most commonly used way to obtain health advice; they also stated that unexpected ill-health is usually accompanied by feelings of fear, anxiety and loneliness. Immigrants, who had visited a public hospital in Greece, identified the language barrier as the most challenging issue, followed by the long waiting lists. Fear and anxiety of hospital visits was an important factor in their decision to vaccinate against COVID-19. Lack of time, high cost of healthy food and lack of knowledge were the most common obstacles to a healthy diet. One in two immigrants reported that they have faced food insecurity issues in the past. Stress, psychological distress and irritation were reported, due to food shortages, especially during the first few years of arriving in Greece. The exclusion of some foods, reduced portion sizes and buying cheaper foods were among the coping strategies to address food shortages.

The study offers an insight into immigrant’s experiences, practices and feelings about managing health issues and could be useful for health-care practitioners, researchers and policymakers.

The purpose of this study is to capture patients' and employees' perception of quality of care in the Indian private hospitals and to find the possible perceptual gaps between both the groups.

Authors have referred to the Victorian patient satisfaction monitoring (VPSM) scale and studied the responses of 327 patients and 327 employees collected from six private Indian tertiary care hospitals. SPSS v26 software was used to conduct the data reliability test, descriptive analysis and Mann–Whitney U test.

Authors have found significant differences in perceptions of quality of care between the patients and employees in the Indian hospitals. Employees have high positive perceptions towards the provided medical care whereas the patients have less favourable perceptions for many quality indicators.

This study findings help the healthcare managers, practitioners and healthcare workers of the Indian hospitals to understand the perceptions of both the employees and the patients towards healthcare quality elements and help to reduce the existing perceptual gap in the process of providing quality healthcare services.

To the best of authors knowledge, this is one of the pioneering studies conducted in Indian healthcare industry to capture and compare the perceptions of both the employees' and the patients' perceptions of various quality of care elements. This study highlighted the existing perceptual gap between the employees and the patients on various healthcare quality elements and indicated the critical areas for improvement to provide high quality healthcare services.

Drawing upon the stimulus-organism-response model, this study aims to explore the impact of soft aspects of service quality on revisit intention through the mechanism of perceived empathy.

For the examination of the hypothesized relationships, the study adopts structural equation modelling to analyse the data of 562 respondents (i.e. 281 family members and 281 inpatients).

The empirical results suggest that service quality increased family member empathy perception, which, in turn, improved inpatients’ revisit intentions.

Past studies have focused on the roles of overall service quality. The authors have extended the literature by examining the specific but important aspect of service quality and its effects on emotional response. Importantly, the study explains that the affective reactions of a patient’s family, fastened with perceived empathy, have a central role in influencing the patients’ subsequent reactions. Moreover, the prior studies collected the data either from hospital employees or patients. However, in the present study, the authors used a unique sample (family members as well as patients) to have a deeper understanding. Thus, the study enhances the literature on the stimuli-response (i.e. service quality – revisit intentions) relationship in the context of service marketing in general and health care in specific. Important academic and managerial contributions and recommendations for future research are discussed.

The scope of this study is to explore and summarize the pool of dimensions, models and measurement techniques of service quality used in healthcare services and to propose a comprehensive conceptual model for practitioners and researchers.

This research employs a comprehensive review of available literature by using multiple keywords on different electronic repositories using the recommendations of the PRISMA approach for the selection of articles. A critical analysis of available studies helped in compiling a list of core service quality dimensions in healthcare services.

This paper presents a comprehensive account of different dimensions and their measurement items used by various researchers to assess service quality in healthcare systems. Most of the researchers have used SERVQUAL model either in its original or modified form while the others have proposed and used totally different dimensions to assess the service quality in healthcare. Many dimensions are just an existing dimension of SERVQUAL that has undergone a name change while others are completely new. The dimensions used by many researchers have items drawn from more than one dimension of SERVQUAL model. The availability of so many dimensions and models adds to the confusion that researchers and practicing managers experience when determining the appropriate model to be used in their work. To mitigate this confusion, there is a need to develop a comprehensive model; the current work is an attempt to meet this need. Through our analysis, we identify four major service quality dimensions: clinical quality, infrastructural quality, relationship and managerial quality and propose a model named CIRMQUAL.

After exploring all available models in the domain of healthcare, this research presents the best possible areas to enhance the quality of healthcare services. It also enhances the research insights for academicians and working professionals by developing and proposing a comprehensive model for measuring healthcare service quality. The proposed model covers almost all of the service quality dimensions used by other researchers and will make the choice of dimensions/model easy for the future researchers/practitioners interested in measuring and improving the quality of services offered by their healthcare units. Such a comprehensive model has not been developed by any researcher thus far.

The successful implementation of hospital projects (HPs) tends to confront sundry challenges in the planning and construction (P&C) phases due to their complexity and particularity. Employing key performance indicators (KPIs) facilitates the monitoring of HPs to advance their successful delivery. This study aims to comprehensively investigate the KPIs for hospital planning and construction (HPC).

The KPIs for HPC were identified through a systematic review. Then a comprehensive assessment of these KPIs was performed utilizing a meta-analysis method. In this process, basic statistical analysis, subgroup analysis, sensitive analysis and publication bias analysis were performed.

Results indicate that all 27 KPIs identified from the literature are significant for executing HPs in P&C phases. Also, some unconventional performance indicators are crucial for implementing HPs, such as “Project monitoring effectiveness” and “Industry innovation and synergy,” as their high significance is reflected in this study. Despite the fact that the findings of meta-analysis are more trustworthy than those of individual studies, a high heterogeneity still exists in the findings. It highlights the inherent uncertainty in the construction industry. Hence, this study applied subgroup analysis to explore the underlying factors causing the high level of heterogeneity and used sensitive analysis to assess the robustness of the findings.

There is no consensus among the prior studies on KPIs for HPC specifically and their degree of significance. Additionally, few reviews in this field have focused on the reliability of the results. This study comprehensively assesses the KPIs for HPC and explores the variability and robustness of the results, which provides a multi-dimensional perspective for practitioners and the research community to investigate the performance of HPs during the P&C stages.

The study aims to investigate the nurse job enjoyment and their participation in medical affairs to enchance the quality of patient care in Saudi hospitals. In addition, this study also investigates the management team's role in patient care quality through the mediating effects of nurse job enjoyment and participation in medical affairs.

The present study used a self-administered survey questionnaire to collect data from registered nurses in Saudi hospitals. In this study, 600 survey questionnaires were distributed online (Google Forms) and received 266 valid responses (44.33% response rate). In addition, SmartPLS-4.0 was applied to validate the research constructs and test the hypotheses via partial least squares structural equation modelling (PLS-SEM).

The study's findings indicate that the job enjoyment of the nurses and participation in medical affairs have positive and significant effects on the quality of patient care. In addition, the research findings also suggest that the management team of the hospitals has a significant indirect influence on the quality of patient care through the medicating effects of nurse job enjoyment and participation in medical affairs.

The findings of this study also offer various practical implications. This study showed the direct impact of the management team on job enjoyment, medical affairs and patient care quality. Therefore, hospital authorities and policymakers may emphasise clear communication, collaboration, respect and trust for the effective management team in providing higher-quality patient care. The present study suggests that hospital policymakers should strive to create a positive work environment, provide adequate resources, foster team spirit, offer incentives and allow flexible scheduling to ensure higher job enjoyment and increase nurse participation in medical affairs.

This study adds to the growing body of knowledge by investigating the effects of the management team, job enjoyment and nurses' participation in medical affairs on patient care quality. This study also enhances the theoretical depth by exploring the mediating impact of job enjoyment in predicting the relationships between the management team and the quality of care provided to patients. The present study provides guidelines for healthcare service providers or practitioners to focus on the nurses' job enjoyment and their engagement in medical activities to continuously improve the quality of patient care in the hospitals.