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Background: With a shortage of geriatricians and an aging population, strategies are needed to optimise the distribution of geriatricians across different healthcare settings (acute care, rehabilitation and community clinics). The perspectives of knowledge users on staffing geriatricians in different healthcare settings are unknown. We aimed to understand the acceptability and feasibility (including barriers and facilitators) of implementing a geriatrician-led comprehensive geriatric assessment (CGA) in acute care, rehabilitation, and community clinic settings. Methods: A qualitative description approach was used to explore the experience of those implementing (administrative staff), providing (healthcare providers), and receiving (patients/family caregivers) a geriatrician-led CGA in acute care, rehabilitation and community settings. Semi-structured interviews were conducted in Toronto, Canada. The theoretical domains framework and consolidated framework for implementation research informed the interview guide development. Analysis was conducted using a thematic approach. Results: Of the 27 participants (8 patients/caregivers, 9 physicians, 10 administrators), the mean age was 53 years and 14 participants (52%) identified as a woman (13 [48%] identified as a man). CGAs were generally perceived as acceptable but there was a divergence in opinion about which healthcare setting was most important for geriatricians to staff. Acute care was reported to be most important by some because no other care provider has the intersection of acute medicine skills with geriatric training. Others reported that community clinics were most important to manage geriatric syndromes before hospitalization was necessary. The rehabilitation setting appeared to be viewed as important but as a secondary setting. Facilitators to implementing a geriatrician-led CGA included (i) a multidisciplinary team, (ii) better integration with primary care, (iii) a good electronic patient record system, and (iv) innovative ways to identify patients most in need of a CGA. Barriers to implementing a geriatrician-led CGA included (i) lack of resources or administrative support, (ii) limited team building, and (iii) consultative model where recommendations were made but not implemented. Conclusions: Overall, participants found CGAs acceptable yet had different preferences of which setting to prioritise staffing if there was a shortage of geriatricians. The main barriers to implementing the geriatrician-led CGA related to lack of resources. Clinical trial number: Not applicable. [ABSTRACT FROM AUTHOR]

ABSTRACT The study of infectious disease dynamics plays an important role in reflecting the transmission mechanisms of epidemics. Compared with the traditional statistical methods, understanding dynamics of an infectious disease can better make people understand some global characteristics of epidemic and help in designing appropriate strategies to control diseases. Early studies of mumps mainly focused on deterministic models. However, environmental noises are inevitable during the spread of infectious diseases. This paper extends a mumps transmission model from a deterministic to a stochastic framework and explores the dynamical behaviors of the model by constructing suitable Lyapunov functions. Our model is a six‐dimensional stochastic model. The construction of suitable Lyapunov functions is very challenging. Firstly, we show that this model has a unique global positive solution for any positive initial values. Secondly, we compute the basic reproduction numbers and present sufficient conditions for the existence of a unique ergodic stationary distribution and the extinction of the disease. Finally, we perform numerical simulations and sensitivity analysis for exploring the effect of some parameters and the white noises on the behavior of the model. The theoretical results can provide necessary guidelines to public health administrators for controlling and preventing diseases. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) has transformed healthcare, yet patients' acceptance of AI-driven medical services remains constrained. Despite its significant potential, patients exhibit reluctance towards this technology. A notable lack of comprehensive research exists that examines the variables driving patients' resistance to AI. This study explores the variables influencing patients' resistance to adopt AI technology in healthcare by applying an extended Ram and Sheth Model. More specifically, this research examines the roles of the need for personal contact (NPC), perceived technological dependence (PTD), and general skepticism toward AI (GSAI) in shaping patient resistance to AI integration. For this reason, a sequential mixed-method approach was employed, beginning with semi-structured interviews to identify adaptable factors in healthcare. It then followed with a survey to validate the qualitative findings through Structural Equation Modeling (SEM) via AMOS (version 24). The findings confirm that NPC, PTD, and GSAI significantly contribute to patient resistance to AI in healthcare. Precisely, patients who prefer personal interaction, feel dependent on AI, or are skeptical of AI's promises are more likely to resist its adoption. The findings highlight the psychological factors driving patient reluctance toward AI in healthcare, offering valuable insights for healthcare administrators. Strategies to balance AI's efficiency with human interaction, mitigate technological dependence, and foster trust are recommended for successful implementation of AI. This research adds to the theoretical understanding of Innovation Resistance Theory, providing both conceptual insights and practical implications for the effective incorporation of AI in healthcare. [ABSTRACT FROM AUTHOR]

Purpose: To assess job satisfaction and burnout levels among Egyptian ophthalmologists in order to better understand their mental and physical well-being. Patients and methods: This is a cross-sectional observational analytic study among ophthalmologists. An online survey was sent out to ophthalmologists. All the participants answered a modified professional quality of life scale including 30 statements related to its three subscales: compassion satisfaction, burnout, and secondary traumatic stress. The responses were anonymized and analyzed. Results: A total of 264 ophthalmologists responded to the survey. The age and duration of work showed a significant positive correlation with compassion satisfaction level (r =0.268, P =0.007, r =0.277, P =<0.001), respectively, and a significant negative correlation with both secondary traumatic stress level and burnout level (r =−0.196 and −0.287, P =0.001 and P <0.001, respectively). Average working hours per day showed a significant positive correlation with compassion satisfaction (r =0.157, P =0.012) and a nonsignificant correlation with other scores (P =0.5, 0.221). There was no significant difference in compassion satisfaction between subspecialties (P =0.512). Both burnout rates and secondary traumatic stress were negatively correlated with age and duration of employment (P =0.001, P <0.001). Burnout rates were low for investigative specialists and high for oculoplasty and surgeons (P =0.428). Seventy two percent of participants reported average secondary traumatic stress level, which was highest among cornea and uveitis specialists and lowest among glaucoma specialists (P =0.027). Conclusion: A significant proportion of ophthalmologists exhibit average levels of burnout and secondary traumatic stress, while their compassion satisfaction tends to improve with accumulating years of practice. The findings highlight a critical need for proactive measures from policymakers, regulatory bodies, and healthcare administrators to identify and address specific risk factors contributing to occupational burnout among ophthalmologists. [ABSTRACT FROM AUTHOR]

In Kenya, persons insufficiently engaged in HIV Testing Services (HTS) are often treated in emergency departments (ED). There are limited data from healthcare workers on ED-HTS. A qualitative study was completed to understand challenges and facilitators for ED-HTS and HIV self-testing (HIVST). Data were collected via six focus groups of healthcare workers. Data were inductively analyzed and mapped to the Capability–Opportunity–Motivation Behavioral Model. Focus groups were completed with 49 healthcare workers: 18 nurses, 15 HIV counselors, 10 physicians and 6 administrators. HTS challenges included staff burdens, resources access, deficiencies in systems integration and illness severity. HTS facilitators included education of healthcare workers and patients, services coordination, and specific follow-up processes. HIVST challenges included accuracy concerns, follow-up barriers and psychosocial risks. HIVST facilitators were patient autonomy and confidentiality, resource utilization and ability to reach higher-risk persons. Mapping to the Capability–Opportunity–Motivation Behavioral Model interventions within the domains of knowledge, decision processes, environmental aspects, social influences and professional identities could support enhanced ED-HTS with integrated HIVST delivery. This study provided insights into challenges and facilitators on ED-HTS and identifies pragmatic approaches to improve healthcare workers' behaviors and abilities to provide services to persons already in contact with healthcare. [ABSTRACT FROM AUTHOR]

The article discusses the investment in nursing leadership to improve strategic planning and execution skills as of January 2025. Topics covered include the leadership curriculum map, the structure and process used for the program, and the nurse executive retreat, four sessions of the leadership development series, and individual coaching. Also noted is the coverage of the cost of investment by the resulting reduction of direct care nurse turnover.

Caregiver coaching is an evidence-based practice for autistic children that is poorly implemented in community-based early intervention. Previous studies have identified factors that influence implementation of caregiver coaching in early intervention; however, multi-informant (e.g., caregiver, provider, leadership) qualitative research is lacking. As such, the purpose of this study was to simultaneously examine the perspectives of caregivers and early intervention providers and agency leaders for triangulation of perceived barriers and facilitators to caregiver coaching in community-based early intervention. Interviews with 36 providers, 6 agency leaders, and 20 caregivers of autistic children were conducted. We used qualitative thematic analysis to identify barriers and facilitators, which we then mapped onto the Consolidated Framework for Implementation Research post hoc. Several themes emerged, including at the outer setting level (i.e., COVID-19 pandemic), inner setting level (i.e., caregiver views toward telehealth), individual characteristic level (i.e., caregiver attitudes toward coaching, caregivers concerns preventing progress, caregiver expectations regarding services, caregiver stress), and implementation process level (i.e., caregiver and provider collaboration, caregiver and provider relationship, caregivers coordinating services, caregiver involvement, provider flexibility). We offer suggestions for implementation strategies that will increase adoption of caregiver coaching in early intervention for autistic children and their families. Caregiver coaching is an evidence-based practice for young autistic children, but it is not widely used in community-based early intervention services. Previous research has explored why caregiver coaching is not widespread in early intervention, but only from the perspective of early intervention providers. Caregivers, providers, and administrators are all involved in the decision of whether to use caregiver coaching in early intervention. Therefore, it is important to include all perspectives in research regarding this practice. In this study we interviewed 20 caregivers of autistic children, 36 early intervention providers, and 6 administrators from early intervention agencies and asked questions about their perspectives regarding the use of caregiver coaching in early intervention. We did this to figure out what factors help and hinder the use of caregiver coaching in this setting and to see how caregivers, providers, and administrators agreed or disagreed on these factors. All participants agreed that caregivers' attitudes and expectations can influence whether caregiver coaching is used. In addition, all participants agreed that when caregivers and providers collaborate and have a strong working relationship, it can facilitate the use of caregiver coaching in early intervention. Other factors, such as caregiver stress and provider flexibility were also discussed. Based on these findings, we suggest strategies that can be used to possibly increase the use of caregiver coaching in early intervention for autistic children and their families. [ABSTRACT FROM AUTHOR]

Background: Proactive behaviors at work refer to behaviors that are self-starting, future focused, and change oriented. Proactive behaviors are generally thought of as positive and desired and can benefit both the employee (e.g., job promotion) and organization (e.g., innovation). These behaviors can, however, backfire (e.g., due to unintended consequences), reflecting the "initiative paradox." Purpose: The aim of this study was to investigate, through the perspectives of health care executives, how employees can be more effective when engaging in proactive behaviors. Methodology: We used the episodic narrative interview method. Health care executives narrated instances of perceived effective and ineffective proactive behaviors among employees. We then performed an inductive qualitative analysis of these episodes to identify emerging themes and dimensions. Results: The effectiveness of proactive behaviors among health care employees is shaped by three dimensions: managerial expectation (in)congruence (e.g., knowledge of expectations, engagement with chain of command), organizational priority (in)congruence (e.g., degree of alignment between individual and organizational benefits), and boundaries of action and change (e.g., nonadherence to regulatory or financial conditions). Among the dimensions, managerial expectations may be the most challenging for employees to navigate. Conclusion: Engaging in proactive behaviors is not a straightforward process. Navigating multiple dimensions is necessary for health care employees to be effective. Practice Implications: Employees should be equipped with knowledge on relevant expectations, priorities, and boundaries when engaging in proactive behaviors at work. Health care leaders and managers should aim to clarify and periodically reassess these dimensions to facilitate effective proactive behaviors and to generate benefits for employees and the organization. [ABSTRACT FROM AUTHOR]

Despite the increasing global burden of mental illness and the availability of effective evidence-based treatments, many individuals with mental illness do not seek professional help. Therefore, this study aimed to assess help-seeking intention for mental illness and associated factors among Dessie town residents, Northeast Ethiopia, 2021. A community-based cross-sectional study was conducted among 501 Dessie town residents. The data were collected by face-to-face interview. The General Help Seeking Questionnaire was used to assess help-seeking intention. Bivariable and multivariable logistic regression analysis techniques were used. Finally, a statistically significant level was declared at a p-value less than 0.05. Among 501 participants, 67.5% were likely to seek help from health professionals. Being female (AOR = 4.695, 95% CI = 1.63– 13.50), being single (AOR = 0.330, 95% CI = 0.12–0.89), and having good knowledge (AOR = 3.030, 95% CI = 1.25–7.35) were significantly associated with help-seeking intention. This study indicated that the participants' help-seeking intention was inadequate. Sex, marital status, monthly income, and knowledge of mental illness were found to be associated with help-seeking intentions for mental illnesses. Therefore, community healthcare workers, healthcare administrators, and religious and community leaders should work to enhance the help-seeking intention of the community. [ABSTRACT FROM AUTHOR]

Background: The implementation of DHIS2 in healthcare systems has transformed data management practices worldwide. However, its specific impact on data quality, availability, and performance in Primary Health Unit (PHU) facilities in Ethiopia remains underexplored. Therefore, we investigated the contribution of DHIS2 to enhancing data quality, availability, and performance within PHU facilities in Ethiopia. Methods: We employed qualitative methods, specifically Key Informant Interviews (KIIs) and Focus Group Discussions (FGDs), to gather insights from stakeholders, including healthcare providers and administrators at PHCUs across Ethiopia. Convenience sampling was used for FGDs, while purposive sampling targeted key informants with relevant expertise. Data were systematically analysed thematically, identifying patterns and themes related to DHIS2's impact on data management within PHUs. This approach offered a comprehensive understanding of the system's effectiveness and the factors influencing its implementation, highlighting both successes and challenges in integrating DHIS2 into healthcare practices. Findings: Participants from various regions reported significant enhancements in the timeliness, completeness, accuracy, and accessibility of health data following the implementation of DHIS2. While some concerns were raised regarding variations in reporting intervals, the consensus indicated marked improvements in data management processes. DHIS2 standardized data collection methods, enabling healthcare providers to input and access data in real-time. This advancement fostered greater accountability and transparency within the healthcare system. Additionally, unexpected benefits arose, including increased digital literacy among staff, equipping them with necessary skills for effective data management, and the creation of job opportunities, particularly for youth. Ultimately, DHIS2 emerged as a pivotal tool for enhancing data quality and promoting health service equity across Ethiopia. Conclusion: DHIS2 has significantly improved data quality and accessibility in Ethiopia, enhancing healthcare management and accountability across facilities. Healthcare providers should continue to leverage its robust features and prioritize ongoing staff training to improve digital literacy and data management skills. Establishing consistent reporting practices and regular audits will further maintain data integrity and foster a culture of accountability within the healthcare system. [ABSTRACT FROM AUTHOR]

Purpose: Rural-dwelling stroke survivors have unmet rehabilitation needs after returning to community-living. Virtual rehabilitation, defined as the use of technology to provide rehabilitation services from a distance, could be a viable and timely solution to address this need, especially within the COVID-19 pandemic context. There is still a minimal understanding of virtual rehabilitation delivery within rural contexts. This study sought to explore the perceptions of rural stakeholders about virtual stroke rehabilitation. Methods: Following an interpretive description approach, 17 qualitative interviews were conducted with stroke survivors (n = 5), caregivers (n = 2), clinicians (n = 7), and health administrators (n = 3), and analyzed to understand their experiences and perceptions of virtual stroke rehabilitation. Results: We identified three overarching themes from the participant responses (1) The Root of the (Rural) Problem considered how systemic inequities impact stroke survivors' and caregivers' access to stroke recovery services; (2) Common Benefits, Different Challenges identified the unique benefits and challenges of delivering virtual rehabilitation within rural contexts; and (3) Ingredients for Success described important considerations for implementing virtual rehabilitation. Conclusion: Virtual rehabilitation is generally accepted by all stakeholders as a supplement to in-person services. Addressing the unique barriers faced by rural clinicians and stroke survivors is necessary to provide successful virtual rehabilitation. IMPLICATIONS FOR REHABILITATION: Understanding the perceptions of virtual rehabilitation from various stakeholders may contribute to more effective provision of stroke services. Understanding unique rural practice challenges faced by clinicians may inform future protocols for virtual rehabilitation. The need for additional support for clinicians and stroke survivors is a determining factor for successful virtual rehabilitation. Incorporating virtual rehabilitation as an adjunct to face-to-face services is accepted by all stakeholders. [ABSTRACT FROM AUTHOR]

China's primary healthcare (PHC) system, together with rural healthcare services, remains the Achilles' heel in the national healthcare system. Healthcare workers, specifically village doctors, are an integral part of the healthcare system. Using the two-stage data envelopment analysis (DEA) and Tobit regression analysis, this study aims to investigate the efficiency of healthcare expenditures on medical resources and services in China, as well as determine how different types of healthcare work influence efficiency. Compared with other types of healthcare workers, village doctors exerted a prominent impact on provincial and rural efficiency at all stages and played a key role in augmenting the efficiency of healthcare expenditures on health outcomes. Besides, township health centers (THCs) and village clinics (VCs) faced administrative overstaffing, mainly involving pharmacists, other nonmedical technologists, and health administrators, which adversely affected the efficiency of healthcare expenditures. This study suggests that the higher the proportion of these non-village doctor positions (e.g., pharmacists, health administrators, and nonmedical technologists) in THCs and VCs, the lower the efficiency of China's PHC system. Overall, the priority should be enhancing the training and remuneration of village doctors and other healthcare workers in rural areas to further enhance their performance and increase the overall efficiency of China's healthcare system. [ABSTRACT FROM AUTHOR]

The article discusses the Virtual Rural Generalist Service (VRGS), a hybrid virtual model of care designed to improve health access and outcomes in rural and remote communities, particularly in Western NSW, Australia. The VRGS aims to provide medical support to rural hospitals with limited onsite medical staff or no local doctors available, integrating patient-centered care, rural proofing, safety and quality measures, leadership and governance structures, service resilience, and digital maturity. The VRGS was launched before the COVID-19 pandemic and played a crucial role in stabilizing the medical workforce during the pandemic, adapting rapidly to meet the increased demand for medical care. The article highlights the positive impact of the VRGS in addressing rural workforce shortages and providing cost-effective, quality medical care in rural and remote areas. [Extracted from the article]

The government of Bangladesh approved the human organ transplantation law in 1999 and updated it in 2018. This legislation approved both living‐related donor and posthumous organ transplantation. The law only allows family members to legally donate organs to their relatives. The main focus of this study was to explore how Bangladeshis make donation decisions on familial organs for transplantation. My ethnographic fieldwork with forty participants (physicians and nurses, a healthcare administrator, organ donors, recipients, and their relatives) disclosed that the organ donation decision was family‐based. An assessment of the relationship between religion, culture, and biomedicine leads to the conclusion that deciding on donating organs to relatives is primarily family‐based and is perceived to be steeped in Islamic ethical principles and religious cultural tradition. The family‐based consent and motivation for donor‐recipient pair organ transplantation strengthen an altruistic environment for the family and act as the moral and legal authority that ensures ethical healthcare outcomes for Bangladeshis. [ABSTRACT FROM AUTHOR]

The global emergence of the unprecedented COVID-19 pandemic in late 2019 has led to millions of infections and thousands of fatalities, profoundly affecting various aspects of life. The continual genetic evolution of the virus highlights the critical need for accurate prognostic tools. In response, this study introduces a machine learning-based approach that leverages the capabilities of Quantum Neural Networks (QNN) to predict the lethal risk of COVID-19 patients, aiming to support physicians and healthcare administrators with insightful data for informed decision-making. Leveraging demographic information and biomarker-based dataset, the Relief method and Matrix factorization feature selection approaches were employed for the feature engineering. In addition, our in-depth descriptive analysis revealed specific demographic factors and comorbidities that intricately contribute to an elevated risk of mortality among COVID-19 patients, emphasizing the nuanced dynamics influencing fatal outcomes. A comprehensive comparative analysis compared QNN with a range of machine learning and deep learning algorithms. The findings demonstrate the potential of our prototype prognostic model in stratifying the mortality risk among COVID-19 patients, offering valuable insights for healthcare professionals to make informed decisions in clinical practice. [ABSTRACT FROM AUTHOR]

Aim: To investigate gender differences in the actual and expected income among psychiatric nurses in China. Background: Although studies have shown that male nurses earn more than female nurses in other countries, there are no published data regarding gender income differences among psychiatric nurses in China. Methods: We conducted a cross‐sectional study involving 41 representative psychiatric hospitals in China. Demographic, income, and job‐related data were analyzed using the inverse probability of treatment weighting (IPTW) based on the propensity score. Findings: The sample included 9256 psychiatric nurses, and nearly four‐fifths (79.3%) were female. Males earned slightly higher average monthly incomes than female nurses, while initial analysis showed no significant overall gender income difference (p > 0.05). Notably, most participants (92.5%) desired an income increase of at least 10%, with over half (56.2%) expressing significant dissatisfaction with their current income. After adjustment using propensity score combined with IPTW, females in the junior and mid‐level groups had significantly lower income than their male counterparts (all p < 0.01), despite having different night shift patterns. However, there were no significant gender differences in actual or expected income among senior‐level psychiatric nurses (p > 0.05). Conclusion: A majority of psychiatric nurses in China express dissatisfaction with their current incomes and expect higher incomes. Male nurses earned significantly more than female nurses in the junior and mid‐level professional groups, potentially due to their differences in night shifts. Implications for nursing policy and health policy: Policymakers and hospital administrators should optimize the income structures of nurses and develop targeted policies to address the gender income gap. Improving nurse income has the potential to enhance motivation and satisfaction within the profession. [ABSTRACT FROM AUTHOR]

Background: Despite nurses receiving education on how to respond during crises, the stress and demands arising from unprecedented situations, such as the COVID-19 pandemic, may affect their work engagement. Aim: To appraise and synthesize studies examining work engagement among nurses in the context of the COVID-19 pandemic. Methods: It is a systematic review in which three databases were searched. Critical appraisal tools and PRISMA guidelines were used. Content analysis was performed. Ethical considerations: Ethical approval was not required for this systematic review. Findings: A total of 21 studies were included. The results were classified into three categories: (1) levels and meanings of work engagement, (2) the relationship of work engagement with various factors, and (3) measures to enhance work engagement. Conclusion: The review revealed that nurses' work engagement varied from moderate to high. Factors such as education level and work schedule flexibility influenced their engagement. Positive associations were found between work engagement and job satisfaction, intention to stay, and organizational support, while stress and workload showed negative relationships. The crucial role of health policymakers, hospital administrators, and nurse managers in acting ethically, creating favorable working conditions and fostering nurses' work engagement was emphasized. [ABSTRACT FROM AUTHOR]

Social risks refer to individuals' social and economic conditions shaped by underlying social determinants of health. Health care delivery organizations increasingly screen patients for social risks given their potential impact on health outcomes. However, it can be challenging to meaningfully address patients' needs. Existing frameworks do not comprehensively describe and classify ways in which health care delivery organizations can address social risks after screening. Addressing this gap, the authors developed the Social Risk ACTIONS framework (Actionability Characteristics To Inform Organizations' Next steps after Screening) describing 4 dimensions of actionability: Level of action, Actor, Purpose of action, and Action. First, social risk actions can occur at 3 organizational levels (ie, patient encounter, clinical practice/institution, community). Second, social risk actions are initiated by different staff members, referred to as "actors" (ie, clinical care professionals with direct patient contact, clinical/institutional leaders, and researchers). Third, social risk actions can serve one or more purposes: strengthening relationships with patients, tailoring care, modifying the social risk itself, or facilitating population health, research, or advocacy. Finally, specific actions on social risks vary by level, actor, and purpose. This article presents the Social Risk ACTIONS framework, applies its concepts to 2 social risks (food insecurity and homelessness), and discusses its broader applications and implications. The framework offers an approach for leaders of health care delivery organizations to assess current efforts and identify additional opportunities to address social risks. Future work should validate this framework with patients, clinicians, and health care leaders, and incorporate implementation challenges to social risk action. [ABSTRACT FROM AUTHOR]

Objective: This study aims to develop a comprehensive chief executive officer (CEO) retention model for Australian hospitals, addressing high turnover rates by integrating key retention strategies to promote organisational stability and enhance patient care. Methods: The study employed a sequential exploratory design with four stages: a scoping review, qualitative interviews, a quantitative survey, and comprehensive data analysis. The scoping review examined existing literature on CEO turnover and retention. Qualitative interviews with 14 Australian hospital CEOs provided in-depth insights. A quantitative survey with 51 CEOs validated the findings. Data triangulation ensured a robust and contextually relevant model aligned with Transformational Leadership Theory and a systems approach. Results: Five key factors influencing CEO retention were identified: mutual respect and clear roles between CEOs and boards, fostering a positive organisational culture, competitive rewards, robust recruitment and retention practices, and ongoing professional development and mentorship. The model emphasises a supportive environment, equitable compensation, effective succession planning, and leadership development. Findings indicate a holistic approach addressing both professional environment and personal growth is essential for improving CEO retention rates. Conclusions: The CEO retention model provides practical solutions to reduce turnover and enhance stability in Australian hospitals. By incorporating Transformational Leadership Theory and a systems approach, the model offers a comprehensive framework that addresses the multifaceted nature of CEO retention. Future research should refine these strategies and explore their applicability in different healthcare settings to further enhance effectiveness. What is known about the topic? High chief executive officer (CEO) turnover in hospitals leads to instability, financial costs, and disruptions in patient care. Effective retention strategies are essential but often lack comprehensive, context-specific models. What does this paper add? This paper presents a tailored CEO retention model for Australian hospitals, integrating mutual respect, organisational culture, competitive rewards, recruitment practices, and professional development, aligned with Transformational Leadership Theory. What are the implications for practitioners? Practitioners can use this model to implement comprehensive retention strategies, enhancing organisational stability and reducing CEO turnover in hospitals. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, many people with intellectual disabilities living in care facilities could not receive visitors. Health authorities suggested the use of digital social contact as an alternative for in-person visits. We examined how people with intellectual disabilities living in care facilities experienced the use of digital social contact with their informal social network throughout 2020. Residents, their relatives, volunteer visitors, direct support staff, and care facility managers (N = 283) completed an online questionnaire, of whom 35 participated in an interview. Video calling and in-person visits were among the most common forms of staying in touch. Experiences with digital social contact depended on residents' abilities and support needs, and on preconditions, such as staff availability. The first phases of the pandemic led to experiences of possibilities and benefits of using digital social contact as complementary to in-person contact for people with different levels of intellectual disability, also after the pandemic. [ABSTRACT FROM AUTHOR]

Background/Objectives: Evidence-based information is crucial for policymakers and providers of mental health and psychosocial services (MHPSS) for unaccompanied asylum-seeking children (UASC). However, there is a scarcity of national-level studies investigating the MHPSS needs of UASC and how these are addressed in Greece. The research objectives of this study were to explore: (a) the psychosocial and mental health needs of UASC living in Greek long-term accommodation facilities as perceived by MHPSS providers, and (b) the range of services across the country, highlighting gaps and best practices in service delivery. Method: An exploratory, predominantly quantitative design was adopted to map UASC's psychosocial difficulties, mental health problems, and MHPSS delivery. Purposive sampling was implemented, with 16 of 17 NGOs operating long-term accommodation facilities for UASC and 16 child and adolescent mental health services (CAMHS) participating. The sample included 79 participants (34 facility coordinators, 28 field psychologists, and 16 CAMHS directors). A 5-W mapping tool (Who, Where, What, When, and Which) was used for data collection, through an online survey. Data analysis involved quantitative and qualitative methods (content analysis). Results: Of 798 minors, almost 59% showed signs of behavioral or emotional disturbance, with over half referred for psychiatric assessment and 27.7% needing inpatient care. Aggression, disruptive behaviors, self-harm, and suicidal ideation were the most challenging issues. CAMHS directors reported a high rate of crisis-driven responses, with 42.1% of UASC needing emergency psychiatric evaluation. Psychosocial support was hindered by communication difficulties, lack of a shared care philosophy, understaffing, job insecurity, and limited resources. Conclusions: Our findings highlight the mental health needs of UASC, and the challenges faced by facility coordinators, psychologists, and community mental health specialists. Future research should focus on the institutional and organizational factors influencing service delivery to improve support for UASC. [ABSTRACT FROM AUTHOR]

Background: Emerging adults are underrepresented in standard behavioral weight loss interventions (BWLIs). Offering BWLIs in college health centers may help to address obesity in emerging adulthood by reducing student barriers associated with participation; however, implementation barriers and facilitators for health centers are unknown. Methods: Health services center administrators and providers (n = 14) and students eligible to participate in a BWLI (n = 9, average BMI = 29.8 ± 4.2 kg/m2) participated in semi‐structured interviews. Interviews focused on the need for and appropriateness of BWLIs in health centers and perceived barriers and facilitators to their implementation. Results: Participants generally believed that BWLIs delivered through a health center were appropriate and indicated that BWLIs would be a beneficial offering on‐campus. Facilitators of health center implementation included availability of trained health professionals, intradepartmental relationships, supportive infrastructure and resources, and in‐house planning and execution. Barriers included limited student use and knowledge of health center offerings, narrow referral/recruitment pathways related to stigma concerns, and challenges related to infrastructure, resources, and competing demands. Conclusions: College health centers are a feasible and appropriate setting to offer BWLIs, though barriers to implementation exist. It will be important to construct a plan for implementation to address unique barriers in health centers prior to BWLI implementation. [ABSTRACT FROM AUTHOR]

Background/Objectives: The principles of value-based healthcare (VBHC) have received widespread endorsement, leading healthcare organizations worldwide to shift their strategies towards them. However, despite growing recognition and acceptance, the actual implementation of value-based approaches varies widely. This research aims to identify studies that address the implementation of VBHC at different levels (healthcare policymakers, hospital administrators, and healthcare providers), focusing on each level's relative strategies. Methods: To this end, a scoping review was conducted in accordance with the PRISMA extension for the scoping reviews checklist. The electronic databases of Web of Science, PubMed, MEDLINE, and Scopus were searched to identify relevant publications in English from January 2006 to 31 July 2023. Results: We identified 30 eligible studies. Findings are organized into four main macro strategic levels, each comprising specific dimensions and operational approaches. Fourteen articles analyzed the role of government commitment in VBHC implementation, while six articles focused on regional integrated care systems. The role of hospitals was described in sixteen records. Conclusions: Our study suggests that a comprehensive approach is necessary for the successful implementation of VBHC. Hospitals emerge as pivotal in this shift, requiring organizational and attitudinal changes among healthcare professionals. However, a complete transition towards VBHC that ensures seamless patient management throughout the entire care delivery value chain necessitates government involvement in terms of state legislation, reimbursement methods, and hospital networking. [ABSTRACT FROM AUTHOR]

Background: Family planning (FP) is part of Ethiopia's essential health service package. However, integrating FP into other health care services is a relatively new concept. Integrated service can minimize missed opportunities and allow health workers to provide FP services and Reproductive, Maternal, Newborn, Child, Adolescent, and Nutrition (RMNCAH-N) services simultaneously. Thus, the objective of this study was to assess the levels of FP integration into maternal and child health (MCH) services at primary health care service delivery units in Ethiopia. Methods: This was a facility-based cross-sectional study conducted from July to October 2022. We conducted a nationally representative survey of primary health care (PHC) facilities selected from seven regions and two-city administrations in Ethiopia to assess the current level of FP integration across four service delivery units (antenatal care unit, postnatal care unit, post-abortion care unit, and immunization unit) of the facilities. We collected data from selected health facilities through interview with health facility managers, healthcare providers in the selected service units, clients seeking health services, and extraction of data from facility records. We employed descriptive analysis, and categorized the degree of FP integration according to the FP information and services provided in the selected service delivery units. Results: This national FP integration survey included 122 health facilities (39 primary hospitals, 42 health centers, and 41 health posts) from seven regions and two city administrations. The study found a huge discrepancy regarding FP counselling given at ANC, PNC, PAC, and immunization service delivery units as reported by health care providers and clients. The proportion of PNC and immunization clients who received FP counselling was higher at health post compared to hospitals and health centers. Moreover, the proportion of PAC clients who received FP information was higher in primary hospitals compared to health centers. Conclusion: Data from facility records and provider interviews showed significant FP integration within ANC, PNC, and immunization units of PHC facilities. However, client exit interviews indicated low FP counselling integration. Facility records revealed few PNC and PAC clients received contraceptives in the past year. The study found high FP counselling and provision of at least one short- or long-acting contraceptive at PNC and PAC units. No facility offered contraceptives at immunization units, indicating missed FP integration opportunities. [ABSTRACT FROM AUTHOR]

Background: General health literacy (general HL) affects both individual and population health on numerous levels, with low general HL leading to increased morbidity, poor health service utilization, and increased healthcare spending. This study calculated health literacy scores of a population attending specialty consultations in the community of Aragon, Spain. It further produced a sociodemographic profile and examined the relationships between patients' scores and sociodemographic variables. Methods: A sample of 150 patients from specialty consultations completed the internationally- validated HLS19-Q12 to measure adult general HL. A 4-point-Likert scale gathered information regarding 12 items of health literacy. Final scores were divided into four categorical levels: excellent, sufficient, problematic, or inadequate. Independent sample t-test, one-way ANOVA, and a generalized linear model (GLM) analysis were performed to examine key relationships with respect to sociodemographic variables and health literacy scores. Results: The survey was completed by 150 subjects aged 18 and over in specialty clinics in Aragon, Spain. 59% of respondents had inadequate or problematic general HL, while 41% had sufficient or excellent general HL. Income level had a significant effect on health literacy scores, F = 2.129, (p < 0.05), as did different work situations, F = 3.762, (p < 0.001). Patients who self-reported as having diabetes had a significantly higher health literacy score, t = 2.356 (p < 0.05) than those reporting other health conditions. According to GLM analysis, education, health status, income, and the number of appointments were the strongest predictors of the heath literacy score. Conclusions: General HL in this patient population was limited, and lower than in some comparable studies. The sociodemographic profile constructed, and associations with health literacy established, provide policy makers, healthcare administrators, and clinicians with information to consider new policies, processes and strategies to improve general HL in this specific population. [ABSTRACT FROM AUTHOR]

Obesity is increasingly recognized as a leading cause of death and is associated with various comorbidities. This study evaluates the relationship between protein score, characterized by the plant-to-animal protein ratio (PAR) and total protein per calorie (Pro%), and body composition: fat percentage (FATP), fat mass (FATM), and fat-free mass (FFM). We categorized 4512 individuals (55.2% female) into tertiles based on their protein score and its components. Male participants in the highest and middle protein score tertiles exhibited significantly greater FFM in both adjusted and crude models, and lower FATP and FATM in adjusted model 2. FFM was elevated in the top (P < 0.001) and middle (P = 0.002) Pro% tertiles in males in both adjusted models and only in the top tertile of all models in females (P = 0.003). The analysis of male participants revealed significantly lower FATP and FATM in the highest tertiles of Pro% in adjusted models. Among female participants, only the highest PAR tertile was associated with significantly lower FATM in adjusted model 1 (P = 0.042). Our findings indicate that protein score and its components are associated with favorable body composition differences. Health administrators may leverage these insights to refine dietary guidelines. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Methodology Findings Discussion This systematic review aims to comprehensively examine up‐to‐date evidence on the economic burden of eating disorders (EDs), both globally and by region.A comprehensive search within five electronic databases, MEDLINE, Embase, CINAHL, PsycINFO, and EconLit, retrieved studies published from August 1, 2013, to June 30, 2024. Cost of illness (COI) studies, burden of disease, and other cost studies that reported costs in monetary values were included, and cost‐effectiveness analysis studies were excluded. The quality of COI studies was assessed using Schnitzler's checklist. All cost estimates were converted into 2024 USD purchasing power parity (PPP). The PROSPERO registration number is CRD42022358136.Twenty‐six studies were identified for inclusion in this review, with 11 COI studies. The nationwide annual financial cost of EDs is estimated at PPP‐USD 70.5 billion. Indirect costs contributed 70%–93% of total financial costs in the reviewed studies. Intangible costs (burden of disease) were estimated to be PPP‐USD 355.6 billion. About half of the COI studies met 60% of the elements of Schnitzler's checklist, either completely or partly.The number of COI studies has more than doubled in the last 10 years. Findings can inform healthcare administrators/policymakers to understand the magnitude of this burden when setting healthcare priorities and allocating resources to maximize social welfare. However, there are variations in the methods (thus quality) and perspectives used to assess this economic burden. Findings suggest that there is potential for enhancing the methodological rigor of future research. [ABSTRACT FROM AUTHOR]

Background: Job satisfaction is the extent to which an employee feels positively or negatively toward their job. Hospitals with high job satisfaction among nurses provide higher-quality nursing care, resulting in higher patient satisfaction. Aims: This study was conducted to determine job satisfaction among nurses in Eastern Mediterranean Region (EMR) hospitals. Methods: This research was a meta-analysis of research on job satisfaction among nurses in EMR hospitals. All studies published in three databases (PubMed, Scopus, Web of Science) and Google Scholar search engine were searched, collected, and assessed for quality. The STROBE checklist was used to determine the quality of the studies. Finally, 13 articles were analyzed using the CMA software. Results: Based on the random effects model, the overall job satisfaction among nurses in EMR hospitals was 17.9% (95% CI (11.9–26.0)). The highest job satisfaction was in hospitals in Palestine. Job satisfaction among nurses was higher in high-income countries than in others. The level of job satisfaction was also higher in private hospitals. Moreover, the results showed that average age and sample size caused heterogeneity between the reviewed studies (p < 0.05). Conclusion: According to the results of this study, about 18% of nurses in EMR hospitals felt satisfied with their job. Therefore, healthcare managers and policymakers in the EMR region must identify and eliminate the causes of dissatisfaction. [ABSTRACT FROM AUTHOR]

Background: There is a need for improved methodologies on how to longitudinally analyze, interpret and learn from the Surveys on Patient Safety Culture™ (SOPS), developed by the Agency for Healthcare Research and Quality (AHRQ). Typically, SOPS quantify results by the percentage of positive responses, but this approach may miss insights from neutral or negative feedback. Study design: The SOPS were distributed every two years from 2011 to 2022 to all hospital staff at one academic institution from perioperative services. Differences between rates of "positive" and "negative" scores ("Delta"), and "neutral" responses over time were calculated. The coefficient of determination (R 2) was used to assess the correlation strength of the positive scores as the primary outcomes provided by the SOPS and Delta values over time. Finally, we evaluated patterns (crossing and converging [indicating "worrisome" patterns] vs. diverging [suggesting "desirable" pattern] vs. stable [suggesting "neutral" pattern]) of the longitudinal scores. Results: A total of 1,035 responses were analyzed [51 and 40 survey items for SOPS v1 and v2 (2022 only), respectively]. Comparing the R 2 values of the positive only scores to the Delta scores demonstrated a change in effect size for "Nonpunitive Response to Error" (R 2 = 0.290 vs. 0.420). Of the 13 specific categories measured through SOPS, plotting negative vs. positive values elucidated 2 crossing, 2 converging and 2 diverging patterns indicating both a decrease in positive responses and an increase in negative responses rather than neutral. Conclusion: Longitudinal analysis of the SOPS using the directional measures, Delta and pattern trends can provide organizations with additional key insights regarding culture of patient safety. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the prevalence and type of clinical pharmacy services offered within South Carolina Federally Qualified Health Centers (SC FQHCs) and identify existing implementation barriers. Methods: This study was a cross-sectional survey of pharmacists or Chief Medical Officers practicing in SC FQHCs. Organizations were identified utilizing the Health Resources and Services Administration (HRSA) database and were contacted to participate in a telephone survey. An electronic form was created in REDCap® software. Descriptive statistics were used to analyze and evaluate data. Results: Twenty-two SC FQHCs were eligible for the survey, with 16 (72.7%) participating. Of the respondents, 9 (56%) offered at least 1 service. The most common services offered were chronic disease state management, diabetes self-management education and support (DSMES), and tobacco cessation (43.8%, n = 7). The least common services offered were chronic care, Hepatitis C, and HIV management (18.9%, n = 3). The most common barriers to implementation were lack of personnel and provider interest (62.5%, n = 10). The least common barrier was a lack of pharmacist interest or time (25%, n = 4). Conclusion: Pharmacists offered at least 1 clinical service within most SC FQHCs. Barriers were identified that prevented expansion of services and further research is needed to overcome these. [ABSTRACT FROM AUTHOR]

Long Term Care Facility (LTCF) residents are particularly vulnerable to infection and showed increased mortality during the COVID-19 epidemic. The pandemic presented multiple new challenges for LTCFs including considering and implementing new practices to protect residents and staff, and figuring out how to minimize the adverse effects of such practices. There are, however, very few reports addressing which public and private entities helped LTCFs meet these challenges. We examined the most important needs of Israeli LTCFs as the COVID-19 pandemic developed, the extent to which their needs were addressed, and by whom, using a survey specifically designed for this study, including open- and close-ended questions. Fifty-two LTCFs participated in the study. Shortages of nursing aids and personal protective equipment were often reported, as was the need for augmented budgetary support. Charitable organizations and the Israeli Army's Home Front Command were reported to provide significantly more assistance than the Israel Ministry of Health, the regulator of LTCFs. The most common type of support provided was distribution of personal protective equipment, followed by provision of training materials or training, and help in maintaining visiting policies. Findings highlight the need for a more coordinated, systematic and comprehensive approach to assist facilities. [ABSTRACT FROM AUTHOR]

Untreated perinatal depression significantly affects the health outcomes of both mothers and infants and increases the economic burden on families and society. Early depression screening to identify at-risk women is essential, and involving key stakeholders ensures the successful integration of best practices within healthcare settings. This study aims are: 1) to identify stakeholders from guidelines and studies that influence the implementation of perinatal depression screening; and 2) to provide a thematic summary of stakeholders' perspectives on the opportunities and challenges for scaling perinatal depression screening. A total of 10 databases were comprehensively searched from their inception until July 28 in 2024, encompassing both Chinese and English literature. Websites of academic organizations were also explored to obtain guidelines pertaining to perinatal depression screening. This study followed the PRISMA guidelines for systematic reviews. Stakeholders' perspectives were analyzed using second-order thematic qualitative analysis. A total of 3268 original articles and 104 guidelines were retrieved. Titles, abstracts, and full texts were screened, resulting in the inclusion of 57 original studies and 9 guidelines for data analysis. The most commonly mentioned stakeholders in perinatal depression screening were health care workers (n = 48) and perinatal women (n = 32), followed by healthcare leaders/managers (n = 16) and policymakers (n = 15). A total 23 articles reported stakeholders' perspectives, from which 291 quotes were extracted. Thematic synthesis identified 12 initial codes, which were summarized into three themes: perinatal depression screening practices, challenges in implementing screening, facilitating factors and opportunities for screening services. This study identified 17 types of stakeholders, with health care workers and perinatal women being the primary groups. Additionally, key challenges in perinatal depression screening were identified, highlighting the need for future research to focus cost, quality, and reimbursement structures to ensure the sustainable and scalable implementation of screening initiatives. [ABSTRACT FROM AUTHOR]

This research was designed to deepen the understanding of contributing factors to disparities in speech-language pathology (SLP) service delivery to children of diverse backgrounds with language and communication delays, as well as to initiate community connections. We sought to understand the perspectives and experiences of those who provide or oversee SLP services to children with communication disorders in early intervention settings in Washington State. Individual semistructured interviews were completed with six SLPs and three administrators across five organizations. The interviews were designed to understand both individual- and systems-level contributing factors to service delivery challenges. Interviews were analyzed using an iterative coding process with multiple rounds of coding and multiple coders. In addition to synthesizing participants' understandings of, and preparation for, culturally responsive practice, three overarching themes are presented: (1) assets of early intervention as a service delivery model, (2) the distance between families and the practitioners and systems that serve them, and (3) compromised access and quality of services due to a predominantly monolingual-English system. Findings inform the next steps for building community partnerships with early intervention organizations. The long-term goal of this work is to collaboratively develop a participatory research program on equitable service delivery that addresses children's, families', and SLPs' needs. [ABSTRACT FROM AUTHOR]

Introduction: Nurses' vigor at work profoundly impacts the quality of patient care. However, the determinants of nurses' vigor remain underexplored in the current nursing literature, and the mechanism through which these determinants exert their effects remains unclear. Aim: This study aimed to elucidate the mediating role of psychological ownership in linking decent work to nurses' vigor at work. Methods: A two‐wave, time‐lagged study was conducted to collect data from 289 nurses working across three hospitals in Port Said, Egypt, between March and June 2023. Data were collected using the Decent Work Scale, the Psychological Ownership Scale, the Shirom–Melamed Vigor Measure, on an Introductory Information Form. Mediation testing was performed using structural equation modeling. Results: Decent work was significantly associated with psychological ownership and vigor at work. Psychological ownership partially mediated the relationship between decent work and nurses' vigor at work. Conclusion: Decent work practices are critical in fostering nurses' vigor while working, and psychological ownership plays a mediating role in this relationship. Clinical relevance: Hospital administrators should value decent work practices, which could enhance psychological ownership, resulting in a potential improvement in nurses' vigor at work. [ABSTRACT FROM AUTHOR]

This narrative review explores the characteristics and outcomes of facility-based quality improvement (QI) projects pertaining to maternal health, conducted over the last decade in low- and middle-income countries (LMICs). The literature on this topic was searched in PubMed, Medline, and Google Scholar, and 33 QI articles were identified. We used the quality standards proposed by the World Health Organization (WHO) quality of care framework for this review. The QI projects were analyzed based on several themes: the methodology adopted in the projects, interventions and outcomes, and common limitations of QI projects. In this review, we found that although LMICs have implemented several QI projects, there is still a deficiency in many key areas. The authors also synthesized 12 key steps that can be followed in future QI projects conducted in LMICs. This review highlights the importance of conducting QI projects in LMICs and encourages health administrators to focus on key areas identified by the authors. [ABSTRACT FROM AUTHOR]

Healthcare organizations worldwide face challenges in retaining their healthcare workforce, with individual and organizational factors influencing their intentions to leave. This study conducted eight online co-creation workshops and four Delphi sessions to gain qualitative and in-depth insights into job retention interventions, involving healthcare workers, hospital managers, and policymakers. A thematic analysis was conducted, resulting in multiple interventions that were clustered in four pre-defined themes: professional and personal support, education, financial incentives, and regulatory measures. Professional and personal support interventions included regular interprofessional team meetings, leadership training programs, self-scheduling and sabbaticals, support for administrative and non-clinical work, and the provision of psychological counselling. Educational interventions encompassed facilitating development opportunities, periodic evaluations, onboarding, mentorship programs, and peer support groups. Financial incentives included the provision of competitive salaries, adequate infrastructure, extra benefits, transport possibilities, and permanent employment contracts. Regulatory measures addressed the need for complementary legislation across various levels, fixed healthcare worker-to-patient ratio, and instruments to monitor workload. To optimize retention strategies, healthcare organizations should tailor these interventions to address the unique factors influencing their workforce's intentions to leave within their specific context. The study concludes that combining personal and professional support, educational opportunities, financial incentives, and regulatory measures is necessary because there is no one-size-fits-all solution. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic forced Principal Investigators (PIs) to make rapid and unprecedented decisions about ongoing research projects and research teams. Confronted with vague or shifting guidance from institutional administrators and public health officials, PIs nonetheless had to decide whether their projects were "essential," who could conduct on-site "essential" research, how to continue research activities by remote means if possible, and how to safely and effectively manage personnel during the crisis. Based on both narrative comments from a federally sponsored survey of over a thousand NIH- and NSF-funded PIs and their personnel, as well as follow-up interviews with over 60 survey participants, this study examines various ways PI and institutional decisions raised issues of procedural and distributive fairness. These fairness issues include the challenge of treating research personnel fairly in light of their disparate personal circumstances and inconsistent enforcement of COVID-19-related directives. Our findings highlight aspects of fairness and equitability that all PIs and research administrators should keep in mind for when future research disruptions occur. [ABSTRACT FROM AUTHOR]

Purpose: 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. Design/methodology/approach: 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. 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. Practical implications: 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. Originality/value: 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. [ABSTRACT FROM AUTHOR]

Background: The knowledge about job demands, control, and support, and their potential associations with burnout risk among physicians in Sweden, is limited. This study aimed to explore (i) factors of the JobDemand-Control-Support (J-DCS) model across different groups of physicians in Sweden, (ii) their association with high burnout risk, and (iii) the potential buffering impact of job control and support. Methods: Cross-sectional data from the Swedish Longitudinal Occupational Health in Healthcare Survey (LOHHCS) study cohort was used. In 2021, a total of 2032 respondents submitted questionnaire data comprising J-DCS measures (i.e., job demands, workplace control and task-level control, and social support from peers and managers). Burnout risk was measured using the Burnout Assessment Tool. Binary logistic regression models were used to investigate the associations between the J-DCS variables and high burnout risk. Interaction analysis was performed to explore any moderation of the associations. Results: Job demands were significantly associated with increased odds of high burnout risk (odds ratio (OR) 2.71, 95% confidence interval (CI) 1.91–3.84. Workplace control (OR 0.50, 95% CI 0.35–0.71) and peer support (OR 0.61, 95% CI 0.48–0.77) were significantly associated with reduced odds of high burnout risk. The interaction analysis showed no significant moderation of the association between job demands and high burnout risk by either peer support or workplace control, and no buffering impact was found. Conclusion: Job demands were associated with high burnout risk among physicians in Sweden. Although workplace control and peer support had inverse associations with high burnout risk, no moderation or buffering impact on the association between job demands and high burnout risk was found. Longitudinal studies are needed to confirm these associations. [ABSTRACT FROM AUTHOR]

Health inequalities continue to exacerbate in the European Region, this underlines the need to strengthen the equity impact of public health policies. Nurses and midwives, professional groups that account for 61.8% of the practicing health professionals, work at the point of care, interdisciplinary and see the effects of health inequalities in their everyday work supporting communities and the environment where they are born, live, work and age. The government chief nursing and midwifery officer (GCNMOs) influence, provide policy advice and lead health systems planning and delivery of services. Further to this, it is increasingly being document that they participate in public health policy and inspire others to commit to the implementation of a new vision to strengthen equity impact on population health outcomes. In 2023, a series of discussions with GCNMOs, multidisciplinary researchers and experts, representing 35 of 53 countries in the WHO European Region explored the implications as to how GCNMOs can contribute to addressing the social determinants of health inequalities. Based on this dialogue, we provide a proposal of public health actions for health equity that will benefit from GCNMOs in delivering co-benefits for better health and inclusive growth. These actions can include equity-responsive health systems and health promotion, universal social protection, secure employment and healthy working conditions, environmental protection, education, decent housing, or urban planning among others. Unless governments facilitate the process where GCNMOs have clear mandates, sufficient authority, recognition, and support to engage in policy advocacy, governments will miss out on building fairer and healthier societies that are truly intersectoral and collaborative. [ABSTRACT FROM AUTHOR]

Introduction: The implementation of fall prevention interventions in homecare services is crucial for reducing falls among older adults and effective leadership could determine success. Norwegian homecare services provide home nursing, rehabilitation, and practical assistance, to residents living in private homes or assisted living facilities. This study aims to explore how managers in Norwegian homecare services experience implementation of fall prevention interventions and how they perceive their roles. Methods: We conducted 14 semi-structured individual interviews with managers from different levels of homecare services in five city districts. The interviews were transcribed verbatim and reflexive thematic analysis was used to analyze the material. Results: The analysis resulted in three main themes: (1) understanding organizational mechanisms to facilitate new practices, (2) practicing positive leadership behavior to facilitate implementation, and (3) demonstrating persistence to sustain implementation. Our results showed the importance of clear leadership across all levels of the organization and the value of devoting time and utilizing existing systems. Managers described using recognition and positive attitudes to motivate employees in the implementation process. They emphasized listening to and involving employees, providing trust, and being flexible. However, the implementation process could be challenging, highlighting the need for managers to be persistent. Conclusion: Managers at all levels play an important role in the implementation of fall prevention, but there is a need to define and align their specific roles in the process. Understanding how to use existing systems and influence through positive leadership behavior seem to be vital for success. Recognizing the demanding nature of implementation, managers emphasized the importance of systems for long term support. The study findings may influence how managers in clinical practice engage in the implementation process and inform future researchers about managers' roles in implementation in homecare services. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to design and test a platform of key performance indicators (KPIs) and indices emphasizing achievements and improvement and helping decision-making. Methods: An operations research study was designed to analyze data from the Hospital Management Information System (HMIS) from July 2017 to June 2018 at the Research Institute of Ophthalmology (RIO), Giza, Egypt. The HMIS data were submitted to reform covering parameters in service delivery and corresponding indicators and indices. Data were grouped into four themes: human resources and outpatient, inpatient, and surgical operations. A total of 14 performance indicators were deployed to four specific indices and total performance indices and applied to six teams of ophthalmologists at RIO. The decision matrices were deliberated to demonstrate achievements and provide recommendations for subsequent improvements. Results: Throughout 1 year, six teams of ophthalmologists (n = 222) at RIO provided the following services: outpatient (n = 116,043), inpatient (n = 8,081), and surgical operations (n = 9,174). Teams 2, 1, and 6 were the top teams in the total performance index. Team 4 had plunges in the outpatient index, and Team 5 faced limitations in the inpatient index. Conclusion: The study provided a model for upgrading the performance of the management information system (MIS) in health organizations. The KPIs and indices were used not only for documenting successful models of efficient service delivery but also as examples of limitations for further support and interventions. [ABSTRACT FROM AUTHOR]

Objective: To explore potential enablers and barriers to accessing paediatric hearing assessment from the perspective of Australian service leads, extending previous studies on this topic from the perspectives of two other stakeholder groups – parents and speech pathologists. Design: This qualitative study, expanding upon previous mixed‐methods studies, applied a pragmatism paradigm. Setting: The study was undertaken online via Zoom and included participants who were service leads of organisations that offer hearing assessment in metropolitan, regional, rural and remote parts of Australia. Participants: Eight Australian service leads participated in semi‐structured interviews. Results: Barriers identified were similar to barriers in previous studies. Three main themes were identified. First, children with hearing loss in Australia are well identified at birth. The second theme focused on the reduced and inconsistent hearing assessment services available after this age. Finally, service leads discussed the importance of embracing technology to solve service access difficulties. Conclusion: Consultation with key stakeholders, to consider the needs of different communities within Australia, will be crucial when identifying new service delivery options. [ABSTRACT FROM AUTHOR]

The role of nurses in leading the design and delivery of primary health care services to address health inequities is growing in prominence, specifically in rural Australia. However, limited evidence exists to inform nurse‐led primary health care in this context. Based on a focus group with nursing executives and semi‐structured interviews with registered nurses we describe nurse experiences of leading the design of a primary health care service in rural Australia and nurse transition to and practice in this service. Nurse experiences were analysed using reflexive thematic analysis. The study reveals the centrality of relational integration in service design and nurse acquisition of relational practice as it relates to nurse to care recipient and nurse to nurse relationships. Tensions between primary health care nurses and their peers, and resultant de‐valuing of primary health care practice, are described. The acquisition of nurse professional agency draws attention to investments required to position nurses to lead and sustain care innovations external to hospital settings. The authors propose that relational approaches may provide nurses with the opportunity to reframe their leadership and service contributions towards community literate primary health care provision and provide a pathway to professional emancipation from constrained practice expectations. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the mediating role of work alienation in the effect of workplace ostracism on employee voice. The research was conducted between 11 December 2020 and 27 April 2021 in Istanbul, Turkey. The research data were collected from employees of private hospitals in Istanbul. The research showed that workplace ostracism has a positive effect on work alienation. It was also determined that both workplace ostracism and work alienation negatively affect employee voice. Finally, it was established that work alienation has a mediating role in the effect of workplace ostracism on employee voice. [ABSTRACT FROM AUTHOR]

Introduction: There is growing popularity of the Hospital Incident Command System (HICS) as an organizational tool for hospital management in the COVID-19 pandemic. We specifically describe implementation of HICS at the Isfahan province reference hospital (Isabn-e-Maryam) during the COVID-19 pandemic and try to explore performance of it. Methods: To document the actions taken during the COVID-19 pandemic, standard, open-ended interviews were conducted with individuals occupying activated HICS leadership positions during the event. A checklist based on the job action sheets of the HICS was used for performance assessment. Results: With the onset of the pandemic, hospital director revised ICS structure that adheres to span of better control of COVID-19. Methods of expanding hospital inpatient capacity to enable surge capacity were considered. The highest performance score was in the field of planning. Performance was intermediate in Financial/Administration section and good in other fields. Discussion: In the current COVID-19 pandemic, establishing HICS with some consideration about long-standing events can help improve communication, resource use, staff and patient protection, and maintenance of roles. [ABSTRACT FROM AUTHOR]

Background/objective: Older patients from long-term care hospitals (LTCHs) presenting to emergency departments (EDs) exhibit a higher prevalence of frailty than those from the community. However, no study has examined frailty in patients from LTCHs in the ED. This study compared frailty in older patients from LTCHs and the community. Methods: We retrospectively analyzed data from the EDs of three university hospitals between 1 August and 31 October 2023, involving 5908 patients (515 from LTCHs and 5393 from the community). The Korean version of the Clinical Frailty Scale (CFS-K) was used to assess individuals aged 65 and older. We compared clinical characteristics, frailty, length of stay (LOS), and diagnosis between patients from LTCHs (LTCH group) and the community (community group). Results: Among ED patients, 55.0% and 35.2% in the LTCH and the community groups, respectively, were frail (p < 0.001). Of these, 71.7% in the LTCH group were hospitalized compared with 53.1% in the community group (p = 0.001). The odds ratio for in-hospital mortality was 4.910 (95% CI 1.458–16.534, p = 0.010) for frail LTCH patients and 3.748 (95% CI 2.599–5.405, p < 0.001) for frail community patients, compared to non-frail patients. Conclusions: Patients from LTCHs with frailty had higher hospital admission rates and increased in-hospital mortality compared to those in the community at the same frailty level. This study offers essential insights into the characteristics of older patients in LTCHs for healthcare administrators and medical staff worldwide. [ABSTRACT FROM AUTHOR]

Objective: Hospital chief executive officers (CEOs) in Australia encounter various challenges such as financial constraints, changing regulations, and the necessity to uphold patient care standards. These challenges can contribute to rates of CEO turnover, which can disrupt healthcare organisations and affect the quality of services provided. This research aims to pinpoint the factors influencing hospital CEO turnover and explore effective strategies for retaining these vital leaders Methods: A survey was carried out among hospital CEOs throughout Australia. The survey, distributed through email and online platforms, gathered information on reasons behind turnover and methods for retaining CEOs. Data from 51 CEOs were analysed using statistical regression techniques and thematic analysis. Results: The findings from the survey indicated that 82.35% of CEOs identified stress and work-related pressure as the causes of turnover. Other significant factors included managing under-resourced organisations (68.62%), lack of support from the board (66.66%), and facing internal/external criticisms (58.82%). On average, respondents reported 5.16 reasons for leaving their positions with no significant differences found based on sociodemographic characteristics. It was pointed out that key ways to retain CEOs include building respect and trust between CEOs and board chairs, meeting the training and development needs of CEOs, and defining roles within the organisation. The importance of succession planning was also emphasised, with 94.12% of respondents acknowledging its significance for maintaining stability. Conclusion: The study underscores the multifaceted nature of CEO turnover in Australian hospitals influenced by organisational dynamics, performance factors, and personal elements. Effective retention strategies necessitate a culture within the organisation, defined roles, sufficient resources, and robust succession planning. Addressing these aspects can bolster leadership continuity and enhance the performance of healthcare organisations. What is known about the topic? High turnover rates among hospital chief executive officers (CEOs) negatively impact organisational stability and healthcare quality, causing disruptions in strategic decision-making, decreased employee morale, and potential declines in patient care standards. What does this paper add? This study identifies stress, lack of board support, and resource constraints as key factors driving CEO turnover in Australian hospitals. It also offers effective retention strategies, including fostering mutual respect between CEOs and boards, fulfilling training needs, and ensuring clear role definitions. What are the implications for practitioners? Implementing supportive organisational cultures, clear role definitions, and robust succession planning can enhance CEO retention. These measures will improve stability, strategic planning, and healthcare management, ultimately benefiting staff and patient care. [ABSTRACT FROM AUTHOR]

BACKGROUND: Efficient allocation of healthcare resources is essential for meeting the increasing demand for healthcare services. This study aimed at exploring the performance of both one- and two-shift Primary Healthcare Centers (PHCCs) and examining the efficiency of healthcare centers to discover how efficiency is affected by the levels of resource allocation and staffing. MATERIALS AND METHODS: The study was conducted at 31 PHCCs assigned to cover extended hours, from 4:00 PM to 8:00 AM during May-October 2023. Study employed a quantitative approach and the data envelopment analysis technique to assess the efficiency of PHCCs, specifically focusing on night shift performance. Data were collected through interviews and surveys with primary healthcare staff including 99 doctors, 119 nurses, and 139 support staff using structured questionnaire. The DEA technique was utilized to measure the relative efficiency of the PHCCs by comparing the inputs and outputs. RESULTS: Out of 31 PHCCs, 45.2% run two shifts. Over the reported period, a total of 126,619 patient visits were recorded; 81.7% came to the two-shift PHCCs and 18.3% to the one-shift PHCCs. On average, each two-shift PHCC received approximately 161 visits/ shift, and the one-shift received 123 visits. Upper respiratory tract infections accounted for 30% of morbidities and chronic diseases for more than 20%. The performance of the two-shifts PHCCs revealed varying levels of efficiency with a score of 1.00 for the most efficient PHCC and 0.31 for the least efficient PHCC. CONCLUSION: This study underscores the importance of data-driven decision-making for healthcare administrators. Ongoing assessments and benchmarking are essential for continuously improving the quality of healthcare service and optimizing utilization of resources. Future research in this field can further explore the factors that contribute to healthcare efficiency and provide deeper insights into healthcare resource management and optimization of service delivery. [ABSTRACT FROM AUTHOR]