Health Services Management Research最新文献

IntroductionHospitals are among the most energy-intensive public infrastructures due to their continuous operations and complex systems. Despite the strategic importance of energy management in healthcare, detailed benchmarks for hospital energy costs remain limited in Italy.MethodsThis study analyzes energy-related facility management expenditures in 27 public hospitals in Lombardy between 2019 and 2022. Data were collected via a structured survey, focusing on electricity and heating expenditures. Parametric values were calculated in €/sqm and hospitals were classified by complexity (Basic, DEA I, DEA II).ResultsThe results reveal that energy costs represent approximately 48% of total facility management expenses. Over the 4-year period, total energy expenditures rose by 51.22%, with the most significant increases in 2021-2022. Parametric values varied by hospital type: from €71.64/sqm in Basic Hospitals to €101.65/sqm in DEA II. Though newer buildings generally showed lower energy costs, building age alone did not fully explain cost variability.ConclusionsThe study provides a first benchmarking effort on hospital energy costs in the Italian context. The findings highlight the need for energy monitoring, retrofitting, and the adoption of efficiency-oriented management strategies, providing actionable insights for infrastructure planning and healthcare policy.

This study assesses physicians' perspectives on the role of ChatGPT in providing health-related information, highlighting its reliability, contributions and potential risks. In a survey of 88 physicians who were selected using convenience sampling, ChatGPT's answers to three different health questions were evaluated, and reliability, benefits and potential hazards were rated on a scale of 1-10. The physicians were then asked about the rationale behind their evaluation scores. The qualitative assessments of the physicians were evaluated together with quantitative analyses of the scores. The results showed high trustworthiness scores across all questions (mean scores of 8.4, 8.2 and 8.6 over 10) and non-significant difference between questions, as well as significant benefits in promoting health literacy through general health advice and lifestyle recommendations (mean scores of 7.3, 7.9 and 8.3). Answer for lowering cholesterol was evaluated at at higher level of contribution than first question (p = 0.0004). However, concerns were raised about risks, particularly due to more direct answers including treatment recommendations, and the potential for misuse by patients was noted (mean scores of 2.6, 3.5 and 2.5). Second question (the treatment for atrial fibration) was evaluated at a higher level of risk (p = 0.002). While ChatGPT has the potential to be an effective tool for health education and promotion, this study underlines the importance of increasing users' health literacy and establishing guidelines to ensure safe and ethical use. The findings highlight the need for multi-stakeholder approaches to optimise the integration of ChatGPT into healthcare settings.

BackgroundGiven the importance of health services delivery, especially under a public-private partnership agreement, attention to the related success factors is overly essential. This study thus intends to explore critical success factors and analyze the agreement of public and private partners on these factors in hospital services.MethodA mixed-method study was conducted; first in a qualitative phase the critical success factors, via 25 face-to-face, semi-structured interviews with the purposely recruited hospital managers, heads of diagnostic services, and managers of private companies were identified. Interviews were then transcribed and analyzed using conventional content analysis, assisted by "MAXQDA-12". In the quantitative phase, the consensus upon these factors were sought using a questionnaire survey and analyzed according to the RAF analysis.ResultsA number of 52 factors categorized under nine main categories represented the key, agreed-upon success factors for implementing PPP. The highest agreement was on the 'Legal aspects of partnership' and the lowest upon the 'Partnership execution'.ConclusionsWeak agreement among the partners could evidently jeopardize the success of any PPP initiative and there is a need for more interaction and negotiation to have a win-win partnership.

Contemporary scholarships in leadership and management increasingly emphasizes the centrality of competent leaders and professionals in enhancing performance at both organizational and system levels, particularly within public health systems facing growing demands for sustainability and reform. Despite initial efforts across various National Health Systems (NHSs) to strengthen managerial capabilities, progress remains constrained by structural path-dependencies and professional bureaucracies. This study investigates the design and implementation of a large-scale, competency-based managerial training program within the Romanian NHS, developed between 2023 and 2024 with the support of the Ministry of Health and the World Health Organization. The intervention followed a multi-phase approach, including a comprehensive literature review and a national needs assessment involving 1200 stakeholders through semistructured interviews and online surveys. A Training-of-Trainers (ToT) scheme was delivered to 150 selected participants by academic experts from Italy, Spain, and Portugal. These trainers subsequently facilitated system-wide training activities, reaching up to 5000 clinical leaders and managers across the country. Findings underscore the strategic relevance of tailored training initiatives in advancing competence-based human resource management. Common training needs identified include leadership, strategic planning, ethics, change management, and systems thinking. The Romanian experience offers transferable insights for designing context-sensitive training programs capable of fostering system-wide organizational transformation in other transitioning health systems.

Background: Identifying the value and quality of organisational models supports the performance of the overall healthcare system and the effectiveness of its processes.Purpose: Based on an organizational case of physiotherapy care delivery, this study compares a traditional organizational model with the most recent fast-track approach within the total hip replacement (THR) surgery pathway.Research Design: Through a Propensity Score Matching (PSM) application, the study aims to analysing the impact of two different models on patient-reported outcomes.Study Sample: Patient-Reported Outcome Measures (PROMs) data collected between 2018 and 2023 through the PROMs Observatory in the Tuscany region (Italy) were used.Results: The results, based on 417 responses, suggest that the two organizational models produce equivalent outcomes reported by patients' voices at different timepoints, while the models have different organizational characteristics that result in increased allocative value in terms of shorter length of stay (LOS) and associated reduced resource use.Conclusions: From a Lean Management perspective, the managers' decision-making process is supported by evidence on the adoption of the most valuable organizational model using both clinical and organizational data from the patient's point of view.

BackgroundGeneral system's theory posits that changing one part of a system will affect other parts of it. Healthcare systems are facing deep changes, but health workforce (HWF) planning methods are not necessarily evolving accordingly. In practical terms, this means that guaranteeing the presence of key professionals able to translate strategies of change into concrete new and effective models of care is problematic.PurposeTo assess whether scholars and managers are indeed tackling key trends of change in healthcare systems when designing and adopting HWF planning tools.MethodsA systematic literature review carried out according to the PRISMA methodology.Results21 articles were included in the final revision. Emerging themes include HWF planning approaches and methods, issues concerning data availability and management of professionals' competencies. Recurrent contents suggest that HWF approaches are not completely anchored to the main trends of change of healthcare systems.Practice implicationsHWF strategies should follow the demand-, supply-, need-taxonomy and should shift from a "professional-centric" to a "job-centric" approach.

This study investigates the perspectives of paramedic educators and students on diversity and inclusion within UK paramedic education, with a focus on the application of the Asset-Based Community Development (ABCD) framework. Using a mixed-methods approach, data was collected from interviews with seven educators, a focus group with four ethnic minority students, a workshop involving 36 third-year students, and a survey completed by 225 students. Educators were predominantly young, White males with limited teaching experience. While many educators were unfamiliar with ABCD, they unknowingly employed asset-based practices and expressed support for its formal integration. Students reported limited ethnic diversity among peers and staff, with some having witnessed discrimination and others highlighting barriers such as cultural insensitivity, inadequate mentorship, and financial pressures. Qualitative themes revealed gaps in communication, a lack of cultural representation and inconsistent support structures. Students saw potential in the ABCD approach to foster inclusivity, but both educators and students stressed the need for institutional commitment. The study concludes that improving diversity in paramedic education requires a multifaceted strategy, including culturally responsive pedagogy, targeted outreach, mentorship programmes and systemic institutional reforms to support ethnic minority learners and enhance equity in educational outcomes.

BackgroundClinician engagement in research is shaped by research capacity building and organizational culture. This study aimed to assess current capacity and culture, and understand factors influencing research engagement.MethodsA sequential explanatory mixed-methods design was used, involving a Research Capacity and Culture (RCC) survey followed by interviews and focus groups at a major metropolitan tertiary hospital. All Health Practitioner and Clinical Assistant staff were invited to participate. Survey data were analysed descriptively, and qualitative data from interviews/focus groups were analysed using Framework Analysis, incorporating the Theoretical Domains Framework. Suggested strategies were mapped to the Theory and Techniques Tool.ResultsSurveys were completed by 105 staff (37.3% response rate), and 23 participated in interviews/focus groups. Survey results showed high skills/success in organizational and team domains, but lower skills in individual domains. Qualitative findings revealed three main themes: (i) individual clinicians, (ii) organizational structure and culture, and (iii) access to support structures. Recommended strategies focused on social supports, incentives, and improving access to knowledge while reducing cognitive load.ConclusionsWhile clinicians recognise research as part of their role, challenges limit engagement. Prioritising practical support (e.g., offline time, clear communication) and developing organizational policies can foster sustained research engagement.

This study explores the dynamics of multiple social networks among healthcare professionals during a process-based reorganization in a hospital department, specifically examining how these relationships influence collaboration and adaptability amidst change. Utilizing a social network analysis framework, we investigate the interplay between advice and subject matter expertise (SME) networks among 67 healthcare professionals in a major Italian hospital. The findings reveal that the presence of multiplex ties-relationships characterized by various forms of interaction-facilitates enhanced collaboration and knowledge sharing, thereby improving the efficacy of organizational change initiatives. Notably, differing intentions regarding change among healthcare professionals can hinder the formation of new ties, indicating the importance of alignment in perceptions for successful network evolution. Ultimately, this study provides valuable insights into the transformative role of social networks in healthcare environments, contributing to a better understanding of how to leverage these networks for improved outcomes in patient care and organizational efficiency.