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Nurse leaders are challenged by ethical issues in today’s complex health-care settings. The purpose of this study was to describe and analyze key elements of moral distress identified by nurse leaders from health-care systems in the USA, Germany, Austria and Switzerland. The aim was to develop an understanding of distressing ethical issues nurse leaders face in the USA and three German-speaking European countries.

This descriptive cross-sectional study surveyed a convenience sample of nurse leaders in the USA, Germany, Austria and Switzerland. The voluntary, anonymous survey also included qualitative questions and was distributed using the Qualtrics® platform. A thematic analysis of the qualitative data in each country was carried out and a comparative analysis identified similarities and differences between the groups of nurse leaders comparing the US data to that from three German-speaking European countries.

The survey was completed by 316 nurse leaders: Germany, Austria, and Switzerland (n = 225) and the USA (n = 91). Similar themes identified as causing all nurse leaders moral distress included a lack of individual and organizational integrity, hierarchical and interprofessional issues, lack of nursing professionalism, patient care/patient safety concerns, finances negatively impacting care and issues around social justice. Within these six themes, there were also differences between the USA and the three German-speaking European countries.

Understanding the experiences associated with distressing ethical situations can allow nurse leaders and organizations to focus on solutions and develop resilience to reduce moral distress in the USA and three German-speaking European countries.

This study aims to explore the empirical correlation between patient flow issues, quality of green health services and patient satisfaction in specialist medical department factors from patients’ perspectives as service consumers.

This research is a type of nonintervention empirical research that uses an open survey to explore the views and experiences of users of specialist medical department services. The targeted population is hospital patients included in the top five national PERSI (Indonesian Hospital Association) Award 2022 Green Hospital Category, with a total number of respondents of 572 people. This study uses the partial least square-structural equation modeling analysis method with the SmartPLS application.

Patient flow problems generally affect the quality of eco-friendly health services, except for the waiting time problem, which affects service quality. It should be understood as a top priority for patients to receive services from medical specialists without risking time as a core service aspect from the patient’s perspective. In addition, all variables in eco-friendly hospital services affect patient satisfaction, except in the case of visits to specialist medical departments, which do not affect medical support services and hospital practices that are responsive to the delivery of care services resulting from medical support services that are inseparable in integrated services as well as health care following medical ethics.

This study has a novelty in understanding the implications of green practice in determining patient satisfaction in medical specialist department as the epicenter of hospital services and the main object of assessment for the quality of hospital services.

Occupational safety issues among employees remains a contemporary and omnipresent concern. In developing countries, safety-related problems are amplified, resulting in higher incidences of serious accidents and occupational diseases. This study aims to evaluate employees’ knowledge and attitudes toward occupational health and safety, and how these influence overall occupational health and safety compliance. Ghana’s oil and gas industry provides the contextual backdrop for this research, given it is characterized by high rates of injury.

A positivist and deductive research strategy was used to quantitatively analyze both primary and secondary data sources. A structured survey was administered to industry employees, and multiple linear regression was used to establish the effects of employee’s knowledge and attitude toward occupational health hazards on overall health and safety compliance.

The findings indicate that most employees had both a high level of knowledge and positive attitude toward mitigating occupational health hazards. Moreover, the study reveals that most employees complied with occupational health safety practices. However, the study also reveals that the effect of employees’ knowledge and attitude toward occupational health hazards does not translate into deployment of comprehensive safety practices. Interestingly, female employees were found to be more knowledgeable and compliant with occupational health and safety practices than their male counterparts.

Premised upon the findings, the study recommends: implementation of relevant education and training programs encompassing the proper usage of machinery and equipment, tailored hazard safety training appropriate to specific employee job requirements, effective dissemination of risk information and governance initiatives that enforce strict adherence to correct safety procedures.

The study uniquely examines the influence of employee’s knowledge of health and safety to overall compliance within the oil and gas industry. Cumulatively, the study’s findings and recommendations contribute to improving the occupational health and safety outcomes within the industry.

This paper aims to overcome the inability of both comparing loss costs and accounting for production resource losses of Overall Equipment Effectiveness (OEE)-related approaches.

The authors conducted a literature review about the studies focusing on approaches combining OEE with monetary units and/or resource issues. The authors developed an approach based on Overall Equipment Cost Loss (OECL), introducing a component for the production resource consumption of a machine. A real case study about a smart multicenter three-spindle machine is used to test the applicability of the approach.

The paper proposes Resource Overall Equipment Cost Loss (ROECL), i.e. a new KPI expressed in monetary units that represents the total cost of losses (including production resource ones) caused by inefficiencies and deviations of the machine or equipment from its optimal operating status occurring over a specific time period. ROECL enables to quantify the variation of the product cost occurring when a machine or equipment changes its health status and to determine the actual product cost for a given production order. In the analysed case study, the most critical production orders showed an actual production cost about 60% higher than the minimal cost possible under the most efficient operating conditions.

The proposed approach may support both production and cost accounting managers during the identification of areas requiring attention and representing opportunities for improvement in terms of availability, performance, quality, and resource losses.

This paper aims to identify the kind of internal climate leaders should offer health-care professionals to promote a patient safety culture in public hospitals managed by social health organizations in Brazil.

Two surveys were applied to health-care professionals working at three Brazilian public hospitals. The internal climate survey reached 1,013 respondents, and the patient safety culture survey reached 1,302 participants. Both factor and regression analyses were used to analyze the study model and determine how internal climate influences patient safety culture.

Results indicate that to promote a patient safety culture among health-care professionals, leaders should generate an internal climate based on trust to foster pride in working in the hospital. Possibly, the trust dimension is the most important one and must be developed to achieve job satisfaction and provide better services to patients.

All the hospitals studied were managed by the same Organização Social de Saúde. Due to the limited responses concerning the respondents’ profiles, demographic variables were not analyzed.

This research reveals that the trust and pride dimensions can most strongly influence a positive patient safety culture, helping hospital leaders face this huge managerial challenge of consistently delivering high standards of patient safety.

This research studies the promotion of a patient safety culture in public hospitals managed by social health organizations, characterized by greater flexibility and autonomy in health-care management and by a greater need for accountability.

This study aims to examine the influence of condominium attributes on resident satisfaction and word of mouth from the perspectives of the elderly in Thailand.

Data were collected from 338 elderly residents through a questionnaire survey and analysed by using descriptive statistics and structural equation modelling procedures.

The results showed that the strongest predictor of resident satisfaction was design functionality, followed by social environment, safety and security and service quality. In addition, the strongest predictor of word of mouth was safety and security, followed by design functionality, proximity, service quality and social environment.

The data were drawn at the level of the overall characteristics of elderly residents. People may be different in terms of their demographic characters such as gender, age, and user experience.

The study suggests that condominium developers and designers should pay attention to design functionality both physically and mentally such as suitable materials, lighting and common areas. Moreover, the developers should focus on the proximity of the nearest hospitals, safety and security measures, well-trained security personnel and social activity arrangement.

Elderly condominium markets are increasingly growing as a result of the ageing society in Thailand. However, very few empirical studies investigate condominium attributes that affect resident satisfaction and word of mouth provided by real estate developers. The paper aims to determine driving factors that enhance the better well-being of elderly residents.

The purpose of this study is to understand the psychological mechanism that affects consumer trust by focusing on the formation and influence process of psychological contracts, and taking this opportunity, explore the influence paths of food quality, food safety and service quality on consumer trust in the online food market, and provide theoretical suggestions for building trust in food businesses' consumers.

This study is based on an empirical investigation and uses partial least square structural equation modeling for analysis. Survey data were collected online from 359 APP users of online food transaction platforms in China.

Food quality, food safety and service quality influence consumer trust through the mediating effects of relational and transactional psychological contracts. However, the differences between these influencing paths are obvious and shift with changes in the marketing channels.

This study contributes to the body of consumer trust research by exploring online food transactions as an emerging trend in China. Some optimization strategies for food quality, food safety and service quality are provided for enterprises involved in online food transactions.

This is a pioneering study revealing psychological contracts as a missing but significant mediator between consumer trust and its antecedents.

The various quality improvement (QI) frameworks and maturity models described in the health services literature consider some aspects of QI while excluding others. This paper aims to present a concerted attempt to create a quality improvement maturity model (QIMM) derived from holistic principles underlying the successful implementation of system-wide QI programmes.

A hybrid methodology involving a systematic review (Phase 1) of over 270 empirical research articles and books developed the basis for the proposed QIMM. It was followed by expert interviews to refine the core constructs and ground the proposed QIMM in contemporary QI practice (Phase 2). The experts included academics in two academic conferences and 59 QI managers from the New Zealand health-care system. In-depth interviews were conducted with QI managers to ascertain their views on the QIMM and its applicability in their respective health organisations (HOs).

The QIMM consists of four dimensions of organisational maturity, namely, strategic, process, supply chain and philosophical maturity. These dimensions progress through six stages, namely, identification, ad-hoc, formal, process-driven, optimised enterprise and finally a way of life. The application of the QIMM by the QI managers revealed that the scope of QI and the breadth of the principles adopted by the QI managers and their HOs in New Zealand is limited.

The importance of QI in health systems cannot be overstated. The proposed QIMM can help HOs diagnose their current state and provide a guide to action achieving a desirable state of quality improvement maturity. This QIMM avoids reliance on any single QI methodology. HOs – using the QIMM – should retain full control over the process of selecting any QI methodology or may even cherry-pick principles to suit their needs as long as they understand and appreciate the true nature and scope of quality overstated. The proposed QIMM can help HOs diagnose their current state and provide a guide to action achieving a desirable state of quality improvement maturity. This QIMM avoids reliance on any single QI methodology. HOs – using the QIMM – should retain full control over the process of selecting any QI methodology or may even cherry-pick principles to suit their needs as long as they understand and appreciate the true nature and scope of quality.

This paper contributes new knowledge by presenting a maturity model with an integrated set of quality principles for HOs and their extended supply networks.

Public safety (communicators; e.g. 9-1-1, police, fire and ambulance call-takers and dispatchers), like many other public safety personnel (e.g. police, paramedics), (re)suffer operational stress injuries (OSIs) that are too often hidden and at a prevalence higher than the general population. Unfortunately, there are very little data for OSI rates in Canadian communicators. To the authors’ knowledge, this is the only pan-Canadian study focusing on organizational culture, and its potential influence on OSIs, within the communicator context.

The authors conducted a 179-item online survey of Canadian communicators comprising 17 validated screenings for occupational stress injuries and symptoms and four open-ended questions relating to their agency's organizational culture. The authors thematically analysed participants' open-ended responses and their screening scores.

A semi-grounded thematic approach revealed that managers and supervisors were significant contributors to negative perceptions (n = 165) of organizational culture, potentially resulting in or worsening existing OSIs. Specifically, leadership was viewed as ineffective, inconsistent, unsupportive, abusive and toxic, with limited understanding of communicator roles. Communicators described feeling devalued, particularly when leaders fail to recognize communicator OSIs, which can perpetuate stigma. Conversely, positive leaders (n = 24) were described as supportive, communicative and encouraging.

The findings suggest that while leadership behaviours are a key factor in employee well-being, it varies considerably across agencies, impacting treatment-seeking behaviours. The authors’ new understandings of leaders' roles in OSIs may help reduce the frequency and severity of communicator OSIs, helping ensure that emergency services are delivered to Canadians.

This research aims to analyze the factors affecting the people's performance working in the health sector to improve the services the health sector provide to society and increase the efficiency of their institutions.

Conceptual model covering paternalistic leadership, employee creativity and psychological safety as an intermediary role has been suggested. A questionnaire was applied to 600 employees of three hospitals in Izmir voluntarily and 531 questionnaire data were obtained to test the proposed model. Statistical Package for the Social Sciences-23 and Amos-18 were the statistical software used to analyze the data.

The results suggest that paternalistic leadership positively affects employee creativity and psychological safety plays a mediating role in this relationship. While the effects of paternalistic leadership on employee resourcefulness are readily available, paternalistic leadership's mechanisms need elucidation.

Previous studies have addressed issues, such as employees' job satisfaction and organizational commitment, covering Far East countries. Yet, the present research's findings enhance the cultural understanding of the conditions, where the paternalistic leader affects employee creativity. Moreover, leader affects must have managerial contributions to institutions.