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The devastating 2014 Ebola outbreak caused human and economic loss, but it also resulted in remarkable improvement in healthcare leadership. The impact is most evident in the affected West African countries of Guinea, Liberia and Sierra Leone. In this chapter, the Ebola experience is used as a framework to explore the essential elements of healthcare leadership, with particular attention to healthcare crises in under-resourced communities. Overall, healthcare leadership presents unique challenges. In common with leaders of other industries, healthcare leaders must inspire others, create a sense of purpose, make difficult decisions and collaborate with a range of people. But, because their focus is on complex systems that aim to improve people's physical and mental well-being, expectations of healthcare leaders are especially high. Their work can be a matter of life or death. For the leader in an under-resourced area, the challenge and expectations are even higher, particularly in the face of new or emerging health threats. The key to effective healthcare leadership is systems thinking which involves looking at the entire system of care as an integrated whole, rather than discrete parts that operate in isolation. Healthcare leaders must understand that health means mobilizing multisectoral knowledge and resources and applying innovative and multiactor approaches to prevent, detect and address health problems. Since the 2014 Ebola crisis, healthcare leaders are increasingly using a systems approach by looking at the culture of health systems, the impact of diseases locally and globally, and the applicability of health interventions in different environments. In the post-Ebola era, steps to strengthen the healthcare system are described which includes the roles of healthcare leaders. These steps include deployment of field epidemiologists and community health agents, community education and fuller use of the One Health Platform, which allows actors from different sectors (human health, animal health and environmental health) to collaborate. Finally, suggestions for healthcare leadership training are offered.

This paper applies systems thinking modelling to enhance the dynamic understanding of how to nurture an innovative culture in healthcare organisations to develop the innovation system in practice and speed up the innovative work. The model aims to provide a holistic view of a studied healthcare organisation's innovation processes, ranging from managerial values to its manifestation in improved results.

The study is based on empirical material from a healthcare unit that, within a few years, changed from having no innovations to repeatedly generating innovations. The study uses the modelling language of causal loop diagrams (CLDs) in the system dynamics methodology to identify the key important aspects found in the empirical material.

The proposed model, based on the stories of the interviewees, explores the dynamics of inertia when nurturing an innovative culture, identifying delays attributed to the internal change processes and system relationships. These findings underscored the need for perseverance when developing an innovative culture in the entrepreneurial phases.

The approach of using systems thinking to make empirical healthcare research results more tangible through the visual notations of CLDs and mental simulations is believed to support exploring complex phenomena to induce and nurture both individual and organisational learning.

The results from this approach provide deepened analysis and provoke the systems view to explain how the nurturing of the culture can accelerate the innovation processes, which helps practitioners and researchers to further expand their understanding of their healthcare contexts.

Recent studies indicated that the level of adoption of health data standards in healthcare organisations remains frustratingly low worldwide although health data standards have been perceived to be an essential tool for interoperability barriers within health information systems. The relevant literature still lacks significant studies concerning the issues of the adoption process of health data standards in healthcare organisations, and in particular those in developing nation. In addressing this gap in knowledge, the purpose of this paper is to investigate the adoption decision of health data standards in tertiary healthcare organisations in Saudi Arabia, and to develop a technology-organisation-environment list that contains the critical factors influencing their adoption.

A multiple-case study methodology was conducted in Saudi Arabia and different data collection methods were used included semi-structured interviews with different decision makers at various levels and departments of the subject organisations, and documents analysis to identify critical factors to the adoption decision of health data standards.

The findings demonstrated a list of key factors from different aspects impacting the adoption decision of health data standards in the subject organisations. The technological factors are complexity and compatibility of health data standards, IT infrastructure, switching costs, market uncertainties, systems integration and enhancing the use of advanced systems. The main organisational factors are the lack of adequate policies and procedures and information management plan, resistance to change, data analysis and accreditation. The core environmental factors are the lack of national regulator and data exchange plan, national healthcare system and the shortage of professionals.

The results from the qualitative data were difficult to generalise to other populations. For example, the structure of the health sector varies from country to country as each health sector has its own characteristics that affect and are affected by national circumstances. In order to provide a more grounded theory resulting from a qualitative study, further examination by conducting quantitative studies is required. In addition, the TOE approach does not take into account the sociotechnical issues and further research is required in this area.

The investigation into the adoption decision of health data standards in tertiary healthcare organisations in Saudi Arabia has led to the development of a technology-organisation-environment list that contains the critical factors influencing their adoption. The research outcome has addressed the gap in knowledge of the adoption of health data standards in healthcare organisations. It also provides the decision maker, and in particular those in developing nations, with better understanding of the adoption process of those standards to better judge and to develop suitable strategy of adoption interventions.

Although recent studies indicated that the level of adoption of health data standards in healthcare organisations remains frustratingly low, the prior studies related to health data standards missed out on the exploration of the adoption decision of different types of health data standards in healthcare organisations and the critical factors influencing their adoption. Research on health data standards adoption based out of a developing country such as Saudi Arabia can also potentially provide several new insights on standards practices.

The purpose of this paper is to reveal the problems associated with unsatisfactory delivery of services in the current healthcare system of China as experienced by patients of diverse social‐economic backgrounds, including service quality, accessibility and affordability.

Summarizing the developmental problems of China's contemporary healthcare system, this article is principally a literature review to investigate interdisciplinary issues, including the role of social medical insurance agency, continuous quality improvement and performance measurement system.

The problems associated with unsatisfactory results of the output from the current healthcare system include the level of quality of services, accessibility and affordability, experienced by the patients of various social economic backgrounds. Developing an integrated system to provide adequate performance measurement complementary with the existing compliance emphasis is suggested, in order to uphold a continuous improvement initiative.

This article is based on interdisciplinary literature review, examining current problems in China's healthcare system and qualitative analysis of the phenomenon. No data are collected to examine the problems identified. In‐depth, ethnographic studies would enable further understanding about the hurdles in the development of a quality healthcare system.

Provides a practical framework for stakeholders to develop an integrated performance measurement system to rationalize resource allocation process that enhances continuous quality improvement.

This paper suggests the adoption of an approach of management science in dealing with China's healthcare system problems and that some fundamental issues found to be critical in developed countries' experience, when striving for performance improvement are not attained under China's current healthcare system. Explores the fundamental issues pertinent to China's current healthcare system and the possible use of performance measurement system for dealing with existing deficiencies.

A healthcare system in any country is rarely the product of one logical policy-making experience, but rather a manifestation of many years of historical development. The purpose of this paper is to examine the characteristics, components, and variables of South Africa’s healthcare system in the context of global patterns. It leverages a dynamic period in South Africa since 1994, and applies a comparative health systems analysis to explain where the country’s healthcare system is, and where it is potentially going.

This paper reviews literature related to South Africa’s healthcare system, outlines its historical development, and discusses three fundamental challenges experienced in the country. This paper also reviews the literature on healthcare system typologies and identifies three framework models that have been used to categorise national healthcare systems since the 1970s. This paper then discusses the categorisation of South Africa’s healthcare system in these models, in comparison to Canada and the USA.

This paper finds that the framework models are useful tools for comparative analysis of healthcare systems. However, any use of such typologies should be done with the awareness that national healthcare systems are not isolated entities because they function within a larger context. They are not static, since they are constantly evolving with many nuances, even with very similar healthcare system categorisations.

This paper charts the trajectory of change in the South African healthcare system, and demonstrates that the change process must keep internal conditions in mind if the outcome is to be successful. Imitating policies of countries with well-functioning systems, without regard to local realities, may not work, as the government attempts to usher in changes within a short span of time.

The primary objective of this article is to examine current procurement, inventory control and management practices in modern healthcare, with a particular focus on the procurement and management of surgical supplies in a prominent public, highly specialized healthcare sector.

This study was conducted in three phases. In Phase 1, the study team interacted with various hospital management stakeholders, including the surgical hospital store, examined the current procurement process and identified challenges. Phase 2 focused on selecting items for a detailed study and collected the qualitative and quantitative details of the store department of the healthcare sector chosen. A detailed study analyzed revenue, output/demand, inventory levels, etc. In Phase 3, a decision-making framework is proposed, and inventory control systems are redesigned and demonstrated for the selected items.

It was observed that the demand for many surgical items had increased significantly over the years due to an increase in disposable/disposable items, while inventories fluctuated widely. Maximum inventory levels varied between 50 and 75%. Storage and availability were important issues for the hospital. It is assumed the hospital adopts the proposed inventory control system. In this case, the benefits can be a saving of 62% of the maximum inventory, 20% of the average stock in the system and optimal use of storage space, improving the performance and productivity of the hospital.

This study can help the healthcare sector administration to develop better systems for the procurement and delivery of common surgical items and efficient resource allocation. It can help provide adequate training to store staff. This study can help improve management/procurement policies, ordering and delivery systems, better service levels, and inventory control of items in the hospital business context. This study can serve as a pilot study to further investigate the overall hospital operations.

This study can help the healthcare sector administration develop better systems for procuring and delivering common surgical items and efficient resource allocation. It can help provide adequate training to store staff. This study can help improve management/procurement policies, ordering and delivery systems, better service levels and inventory control of items in the hospital business context. This study can serve as a pilot study to further investigate the overall hospital operations.

This study is an early attempt to develop a decision framework and inventory control system from the perspective of healthcare inventory management. The gaps identified in real hospital scenarios are investigated, and theoretically based-inventory management strategies are applied and proposed.

Given the pace of industry change and the rapid diffusion of high reliability organization (HRO) approaches, lags and divergences have arisen between research and practice in healthcare. The purpose of this paper is to explore several of these theory-practice gaps and propose implications for research and practice.

Classic and cutting-edge HRO literature is applied to analyze two industry trends: delivery system integration, and the confluence of patient-as-consumer and patient-centered care.

Highly reliable integrated delivery systems will likely function very differently from classic HRO organizations. Both practitioners and researchers should address conditions such as how a system is bounded, how reliable the system should be and how interdependencies are handled. Additionally, systems should evaluate the added uncertainty and variability introduced by enhanced agency on the part of patients/families in decision making and in processes of care.

Dramatic changes in the sociotechnical environment are influencing the coupling and interactivity of system elements in healthcare. Researchers must address the maintenance of reliability across organizations and the migration of decision-making power toward patients and families.

As healthcare systems integrate, managers attempting to apply HRO principles must recognize how these systems present new and different reliability-related challenges and opportunities.

This paper provides a starting point for the advancement of research and practice in high-reliability healthcare by providing an in-depth exploration of the implications of two major industry trends.

The purpose of this paper is to explore inter-organizational interactions that might result in prolonged decoupling between central governments' ideas and local governments' practices during the reform of an institutional field (i.e. healthcare).

The paper is based on a qualitative study of the centrally directed reform of the healthcare financing system in Ukraine and focusses on practices and reform ideas from 1991 to 2016.

The findings show that, for more than 25 years, local governments, as providers of healthcare services, faced two major problems associated with drawbacks of the healthcare financial system: line-item budgeting and fragmentation of healthcare funds. Over 25 years, central government's attempts to reform the healthcare financing system did not comprehensively or systematically address the stated problems. The reformers' ideas seemed to focus on creating reform agendas and issuing new laws, instead of paying attention to challenges in local practices.

This article has two main points that are relevant for practitioners. First, it calls for greater involvement from local actors during all stages of public sector reforms, in order to ensure the relevance of developed reform strategies. Second, it points to potential challenges that central governments may face when conducting healthcare financing system reforms in transitional economies.

The paper's contribution is twofold: it outlines reasons for problematic implementation of healthcare financing system reform in Ukraine and explains them through a “reverse decoupling” concept.

The pandemic has reinforced the need for revamping the healthcare service delivery systems around the world to meet the increased challenges of modern-day illnesses. The use of medical cyber–physical system (MCPS) in the healthcare is one of the means of transforming the landscape of the traditional healthcare service delivery system. The purpose of this study is to critically examine the impact of MCPS on the quality of healthcare service delivery.

This paper uses an evidence-based approach, the authors have conducted a systematic literature review to study the impact of MCPS on healthcare service delivery. Fifty-four articles were thematically examined to study the impact of MCPS on eight characteristics of the healthcare service delivery proposed by the world health organisation.

The study proposes support that MCPS will positively impact (1) comprehensiveness, (2) accessibility, (3) coverage, (4) continuity, (5) quality, (6) person-centredness, (7) coordination, (8) accountability and (9) efficiency dimension of the healthcare service delivery. The study further draws nine propositions to support the impact of MCPS on the healthcare service delivery.

This study can be used by stakeholders as a guide point while using MCPS in healthcare service delivery systems. Besides, healthcare managers can use this study to understand the performance of their healthcare system. This study can further be used for designing effective strategies for deploying MCPS to be effective and efficient in each of the dimensions of healthcare service delivery.

The previous studies have focussed on technology aspects of MCPS and none of them critically analysed the impact on healthcare service delivery. This is the first literature review carried out to understand the impact of MCPS on the nine dimensions of healthcare service delivery proposed by WHO. This study provides improved thematic awareness of the resulting body of knowledge, allowing the field of MCPS and healthcare service delivery to progress in a more informed and multidisciplinary manner.

There is an increasing interest in employing e‐mail or other Internet‐based messaging systems in communication between patients and healthcare professionals. Many projects are put into practice, and numerous studies shed light on patients’ preferences regarding e‐messaging and their experience and use of e‐messaging. We argue in this paper that the conventional research in the field to some extent lacks a discussion about what kinds of knowledge an e‐messaging system generates among its users when it is put into practice. We suggest that placing the concept of knowledge as a discourse in focus, stressing how patients make judgements and distinctions in their use of e‐messaging, exposes important aspects not only regarding how patients relate to the system but also what e‐messaging in the healthcare sector means. We illustrate such a perspective with empirical material based on two focus groups of users of an e‐messaging system via a Swedish healthcare Web portal. Three kinds of knowledge formations are illuminated in this context: how patients develop knowledge by comparing e‐messaging services with traditional ways to contact healthcare; how the system generates a further demand for control by its users; and how the e‐messaging system helps users develop knowledge of the healthcare system in general.