Hospitals, Volume 2, Issue 3 (September 2025) – 3 articles

This study analyzes the comparative performance of ten hospitals in the Kadutu Health Zone in the Democratic Republic of Congo using the EGIPSS model. This study was carried out at the height of the COVID-19 pandemic in August and September 2021, in a changing global context where health systems were called upon to improve their resilience capacity while maintaining high levels of performance. This is a descriptive observational study using documentary review, interviews with 85 key informants, and participatory observation at ten hospitals selected based on several criteria, including the organization of a complete complementary package of activities assigned to a hospital in the DR Congo. This study mainly reveals three facts, namely that (i) university hospitals show the best performance, (ii) adaptive capacity considerably influences the other dimensions of the EGIPSS model and the overall performance of the hospital, and (iii) to adapt, hospitals need resources and good management and governance. Adapting hospitals in the Kadutu Health Zone to the changing context requires a holistic approach that combines clinical work with research, investments in infrastructure (often dilapidated and not modern), training, technology, and governance. It also involves learning from practices implemented in more efficient hospitals. Full article

The majority of Australians who die each year do so in an acute hospital setting and are cared for during the end of their life by a multidisciplinary team comprising nurses, medical staff, and allied health staff. Despite the range of professional disciplines that services this patient group, the experiences of the staff providing this end-of-life care is not well understood. This study sought to explore the experiences of multidisciplinary staff providing this care at an acute hospital in Sydney, Australia and to identify the barriers that affect the end-of-life care provided. Data were collected through an online survey from a multidisciplinary sample group. A combination of statistical analysis and thematic analysis was used to analyse the data with four key themes emerging. These themes included the implications for staff working in end-of-life care, communication gaps in the acute hospital setting, recognition of the dying process, and improvement of end-of-life care through further education. This study highlighted the challenges experienced by healthcare staff in the end-of-life context, with recommendations provided for increased education and training. The need for staff to receive training with a focus on end-of-life skill development, professional confidence, and preparedness for end-of-life conversations was highlighted. Full article

Healthcare is a dynamic and ever-changing phenomenon and is subject to multiple challenges, particularly concerning sustainability and cost issues. The literature identifies bed space and problems related to the lack of hospital beds as being directly or indirectly related to both admission and discharge processes, with delays in in-patient discharges being identified as a variable of significance when it comes to a health system’s overall performance. In this respect, the aim of this research was to explore factors related to delayed discharges in an acute hospital setting in Malta, a small European member state, through the perspectives of health professionals. This study followed a qualitative approach. Semi-structured interviews (n = 8) and focus groups (n = 2) were conducted with a diverse group of experienced health professionals. Informed consent was obtained from all participants, and all data were treated with strict confidentiality throughout the study. The sample was limited to professionals working in adult, non-specialized healthcare settings. Manual thematic analysis was carried out. Codes were grouped to derive seven main themes, which were identified after carrying out the thematic analysis process on the transcripts of the interviews/focus groups. The derived themes are the following: (a) a faulty system, which is open to abuse and inefficiency, (b) procedural delays directly impacting delayed discharges, (c) long-term care/social cases as a major cause of delayed discharges, (d) the impact of external factors on delayed discharges, (e) stakeholder suggestions to management to counteract delayed discharges, (f) the impact of COVID-19 on delayed discharges, and (g) inter-professional relationships. Factors related to delayed discharges and the effects of delayed discharges on the hospital emerged from the main findings, together with specific potential interventions to minimise delays in discharge. Health professional interactions and the effects of inter-professional relationship setbacks on delayed discharges were explored, and the impact of the COVID-19 pandemic on hospital dynamics and additional delays were also addressed. This information is intended to provide hospital administrators with data-driven internal organisational evidence to guide them through changes and to inform future decisions regarding hospital performance and efficiency from a discharge delay perspective. Full article