Hospitals, Volume 2, Issue 2 (June 2025) – 5 articles

The effective and financially sustainable shift towards outpatient care in hospitals requires adjustments in infrastructure, processes, and personnel. This contribution validates and extends the existing literature by conducting expert interviews in Switzerland and Germany. Establishing transparent cost and performance data is a crucial first step. Subsequently, key organizational success factors—such as spatial and functional planning, staffing concepts, digital and AI-assisted process optimization, and collaborations—must be adapted. The findings indicate that there is no universal approach to outpatient integration. However, the adaptation of these success factors and the insights gained serve as essential milestones towards an economically viable hospital-based outpatient care model. Full article

Expensive medical devices, especially in the areas of orthopedics, and cardiology, have a significant impact on hospital costs and the delivery of high-quality services. These medical supplies are known as physician preference items (PPIs), as they act as “surrogate buyers”—impacting the selection and sourcing of products. There is a gap between the purchasing strategy and the adoption of tactical activities for these complex medical supplies. In the context of the healthcare exceptionalism thesis, this research investigates how healthcare organizations can successfully adopt suitable sourcing levers aiming to achieve different purchasing results. This research conducts a multi-case study in 15 healthcare organizations in nine countries. Three new sourcing levers specific to the healthcare sector emerged, based on the healthcare exceptionalism thesis. It was possible to identify five main sourcing levers clusters. The fit between strategy and tactical level can be allowed by the implementation of suitable sourcing levers—facilitating the achievement of the desired objectives. Healthcare procurement practitioners should assess the fit between strategy and the tactical level by employing suitable sourcing levers. Organizations wishing to move towards a value-based procurement approach should adopt a set of supporting sourcing levers to enable this transition. Full article

Background: Yemen faces significant challenges related to drug smuggling and counterfeiting, exacerbated by socio-economic hardships and a fragile healthcare and regulatory system. These conditions create an environment conducive to illicit drug trafficking. This study aims to explore the perspectives of healthcare employees working in drug-related departments in the Capital Sana’a, Yemen, focusing on the factors contributing to drug smuggling and the broader challenges within Yemen’s pharmaceutical sector. Methods: A cross-sectional study was conducted among health employees in drug-related departments in the Capital Sana’a. Data were collected through a self-administered questionnaire and analyzed using SPSS version 22.0. Descriptive and inferential statistical analyses were performed to examine group differences, including t-tests and ANOVA. A significance level of p < 0.05 was considered statistically significant. Results: The t-test indicated significant disagreement among participants (50.3%) regarding the existence of a comprehensive pharmaceutical policy (p < 0.001). High levels of agreement were observed on commonly smuggled drugs (74.7%) and the underlying reasons for drug smuggling and counterfeiting (76%, p < 0.001). A significant gender difference emerged regarding perceptions of the Supreme Board of Drugs’ role, with males scoring lower (mean = 2.86, SD = 0.81) than females (mean = 3.43, SD = 0.42, p = 0.002). However, ANOVA results showed no significant differences within or between groups based on educational qualifications, professional roles, or years of service concerning pharmaceutical policy, the Supreme Board of Drugs, registration requirements, or drug smuggling and counterfeiting (p > 0.05). Conclusions: This study highlights critical challenges in Yemen’s pharmaceutical sector, including systemic weaknesses, policy gaps, and the prevalence of drug smuggling, while emphasizing the pivotal role of health employees in addressing these issues. Strengthening their capacity through targeted interventions—such as training, awareness campaigns, robust regulatory frameworks, equitable enforcement, and enhanced stakeholder engagement—is essential. Given the cross-border nature of drug smuggling, these findings underscore the urgent need for strengthened international cooperation, harmonized regulatory policies, and intelligence-sharing mechanisms to combat illicit pharmaceutical trade. Addressing these challenges at both national and international levels is vital for ensuring drug safety, protecting public health, and mitigating the global impact of counterfeit and smuggled medicines. Full article

Effective nurse leadership increases nurses’ job satisfaction, performance, motivation, and empowerment. Ensuring nurses’ organizational and professional commitment is vital for addressing quality, sustainability, and cost-effectiveness challenges in a high-demanding healthcare environment. The aim of this study was to explore the impact of transformational leadership on nurses’ organizational and professional commitment. A systematic review was conducted using the Scopus, ScienceDirect, PubMed/Medline, Scilit.net, and Wiley Online Library databases. Original research studies published between 2016 and 2024 focusing exclusively on nurses’ professional and organizational commitment and transformational leadership were included. The indexing terms “nursing leadership”, “transformational leadership”, “professional/organizational commitment”, and “nursing” were used along with the Boolean operators AND, OR, and NOT. According to the findings, transformational leadership practices increase nurses’ organizational and professional commitment through vision sharing, motivation, career development, interpersonal communication, a positive working environment, and productive resources management. The healthcare policy makers should invest in organizing, supporting, and promoting relational leadership practices to retain their nursing workforce and obtain their organizational and professional commitment to ensure high care quality. Full article

Background: The rapid expansion of telemedicine globally, especially during the COVID-19 pandemic, has been critical for maintaining the continuity of chronic care, including in low- and middle-income countries (LMICs). In the context of maintaining health services during major hazards, telemedicine offers a potential solution for reducing the impact of associated disruptions and maintaining the functionality of hospitals. This study aims to evaluate the application of telemedicine for chronic diseases in LMICs during COVID-19, with a focus on its role in enhancing health system resilience during disastrous events. Methods: A systematised review was conducted by searching PubMed, Scopus, Global Health, and Google Scholar for primary literature published between January 2020 and July 2023. English-language articles on chronic disease management were targeted; they were freely accessible and excluded abstracts, conference papers, posters, and grey literature. A multilevel evaluation framework was applied, covering access, cost, patient and health worker experiences, and the effectiveness of telemedicine interventions. Results: After screening one thousand six hundred seventy-eight records, twenty-three studies and two additional snowball-sourced papers from ten countries were included. Findings revealed that while telemedicine enhanced access to care, patient experiences, and effectiveness, cost analysis remains an understudied area. Discrepancies in perspectives were noted between patients and health workers, particularly regarding access and effectiveness. Nevertheless, the majority of studies agree on telemedicine’s positive impact on the accessibility and resilience of health systems during major emergencies, which reduces costs and improves the overall patient experience. However, concerns such as outdated regulations and policies and poor internet connectivity pose a challenge that needs to be addressed. Conclusions: This review highlights the potential of telemedicine in strengthening health system resilience, particularly in LMICs where more work is needed to update regulations and policies and to strengthen infrastructure for more affordable and uninterruptable connectivity. Further research is needed to explore the long-term sustainability of telemedicine in these contexts and to identify strategies for successful implementation across diverse public health challenges. Full article