Search Results (408)

Background/Objectives: Vast amounts of textual data are generated by healthcare organizations every year. Traditional content analysis is time-intensive, error-prone, and potentially biased. This study demonstrates how freely available large language model (LLM) artificial intelligence (AI) tools can efficiently and effectively analyze qualitative healthcare data and uncover insights missed by traditional manual analysis. Interview data from chief nursing officers (CNOs) at top-performing academic medical centers were analyzed to identify factors contributing to their operational and patient quality success. Methods: Semi-structured interviews were conducted with CNOs from top-performing academic medical centers that achieved top-decile quality measures while using resources most efficiently. Interview transcripts were analyzed using a mix of traditional text mining in LSA and Gemini 2.5. The capability of four freely available AI platforms—Gemini 2.5, Scholar AI 5.1, Copilot’s Chat, and Claude’s Sonnet 4.5—was also reviewed. Results: LLM AI analysis identified ten primary factors, comprising twenty-four subtopics, that characterized successful hospital performance. Notably, AI analysis identified a theoretical connection that manual analysis had missed, revealing how the identified framework aligned with Donabedian’s seminal structure, process, outcomes quality model. The AI analysis reduced the required time from weeks to nearly instantaneous. Conclusions: LLM AI tools offer a transformative approach to unlocking insight from the analysis of qualitative textual data in healthcare settings. These tools can provide rapid insight that is accessible to personnel with minimal text-mining expertise and offer a practical solution for healthcare organizations to unlock insight hidden in the vast amounts of textual data they hold. Full article

Background: Teamwork and effective communication are widely recognized as essential pillars for the safety and quality of healthcare. However, in Portugal, no validated instrument had previously been available to assess healthcare professionals’ attitudes toward teamwork. This study aimed to translate, culturally adapt, and validate the TeamSTEPPS^® Teamwork Attitudes Questionnaire (T-TAQ) for the Portuguese context, resulting in the Portuguese version of the instrument. Methods: A methodological study with a quantitative approach was developed. The translation and cultural adaptation process followed internationally recognized guidelines. The sample consisted of 162 healthcare professionals (136 nurses and 26 physicians) from a hospital in Lisbon. Exploratory and confirmatory factor analysis techniques were used to assess construct validity. The internal consistency of the scale was analyzed using Cronbach’s alpha coefficient. Results: The Portuguese version comprises 30 items distributed across five dimensions: Effective Leadership Support, Team Functional Performance, Teamwork Coordination, Willingness to Engage in Teamwork, and Team Functioning Supervision. The scale demonstrated a total explained variance of 53.9% and an overall internal consistency coefficient (α) of 0.86, indicating good reliability. Confirmatory factor analysis supported the five-factor structure of the scale (χ²/df = 1.461; CFI = 0.900; GFI = 0.821; RMSEA = 0.054; MECVI = 4.731). Conclusions: The T-TAQ-PT proved to be a valid, reliable, and robust instrument for assessing healthcare professionals’ individual attitudes toward teamwork, contributing to the development of research and clinical practice in the Portuguese context. Full article

Background/Objectives: Digital transformation is increasingly essential for healthcare organizations to improve operational efficiency and service quality. However, in developing countries such as Indonesia, many lower-middle-class hospitals lag due to limited financial, human, and infrastructural resources. This study examines how environmental dynamism—comprising regulatory changes, market pressures, and technological shifts—affects the digital capabilities of these hospitals. Methods: A quantitative, cross-sectional survey was conducted in Class C and D hospitals across Indonesia. Respondents included hospital directors, deputy directors, and IT heads. Data were collected through structured questionnaires measuring environmental dynamism and digital capability using a six-point Likert scale. Reliability testing yielded Cronbach’s alpha values above 0.96 for both constructs. Correlation analysis was performed to examine the relationship between environmental dynamism and digital capability. Results: Findings reveal a weak positive correlation (r = 0.1816) between environmental dynamism and digital capability. Although external factors such as policy regulations and technological competition encourage digital adoption, hospitals with limited internal resources struggle to translate these pressures into sustainable transformation. Key challenges include low ICT budgets, inconsistent staff training, and insufficient infrastructure. Conclusions: The results suggest that environmental change alone cannot drive digital readiness without internal capacity development. To foster resilient digital healthcare ecosystems, policy interventions should integrate regulatory frameworks with practical support programs that strengthen resources, leadership, and human capital in lower-middle-class hospitals. Full article

Assisted Reproductive Technology Units (ARTUs) constitute a rapidly growing sector in healthcare, where service quality and patient safety are closely intertwined with ethical principles, technological precision, and managerial efficiency. This study aims to explore quality management practices and certification standards—such as ISO 9001, ISO 15189, and ISO 13485—within ARTUs, with the goal of developing a model that enhances patient-centered outcomes. The analysis focuses on the roles of leadership, staff training, and internal auditing mechanisms as key factors for the successful implementation of quality management systems (QMSs). Through a structured literature review and thematic synthesis, this study identifies challenges that ARTUs face in aligning with international standards and highlights strategies that strengthen patient trust, transparency, and continuous improvement. The proposed model connects measurable quality indicators with patient perceptions and experiences, providing a comprehensive framework for sustainable quality development. This article contributes to the academic discourse on healthcare quality governance and offers practical insights for policymakers and administrators seeking to improve patient experience and organizational resilience in reproductive medicine. Full article

Background: The healthcare industry demands nurses with both clinical proficiency and leadership skills. However, formal leadership training remains limited among undergraduate nursing students, underscoring the need for clinical mentorship to support leadership development. Purpose: This study investigated the association between clinical mentorship quality and leadership competencies among undergraduate nursing students enrolled at a public university in northern Saudi Arabia. Methods: Data were collected using a cross-sectional design from 224 nursing students through a self-administered online survey, which comprised three sections: demographic information, students’ perceptions of clinical mentorship quality, and a standardized assessment of leadership competencies. Results: Students reported positive perceptions of their leadership competencies, with an average score of 2.82. A strong positive correlation was observed between mentorship quality and leadership competencies, particularly in strategic thinking, emotional intelligence, influence, and teamwork. Differences were observed based on sex and academic performance, with female students and those with higher GPAs exhibiting stronger leadership competencies. Regression analysis revealed mentorship quality (β = 0.642, p < 0.001) and academic performance (β = 0.131, p = 0.013) as significant predictors of leadership competencies, while gender and academic year were not statistically significant. Conclusions: High-quality clinical mentorship substantially contributes to the development of leadership competencies among nursing students, with academic performance providing additional support. Integrating structured mentorship programs into nursing curricula may enhance preparedness for leadership roles within healthcare settings. Full article

Knowledge-sharing is a deliberate exchange of information to enhance accessibility and reuse which is critical for improving healthcare delivery. This study assessed knowledge-sharing practices among dentists, pharmacists, and allied health professionals (AHPs) in nine public hospitals in South Africa’s Eastern Cape Province. A cross-sectional survey was conducted using purposive and stratified random sampling to recruit 99 participants. Data were collected via a validated questionnaire and analysed with SPSS v.22.0 using descriptive statistics. Respondents were predominantly female (77.6%) and aged 21–35 years (63.6%); AHPs comprised 65.7% of the sample. The results show a statistically significant association between profession and encouragement to adopt a global perspective (p = 0.017), while significant differences were observed between profession and encouragement to seek inter-team solutions (p = 0.020), and access to leadership-driven opportunities for interdisciplinary knowledge-sharing (p = 0.016). Despite observable patterns in the descriptive results, no other statistically significant differences by profession were observed for all other items. Collaboration with external communities and leadership-driven knowledge-sharing opportunities were also highest among dentists but limited overall. Adoption of information systems for knowledge exchange was low, particularly among pharmacists and AHPs. Participation in professional development and recognition of long-term knowledge-sharing strategies followed similar patterns. These findings highlight the need to strengthen leadership-driven opportunities for interdisciplinary knowledge-sharing and to develop targeted interventions to address specific gaps between professions. Full article

Background/Objectives: While nurses showed a willingness to work during the pandemic and wartime, little is understood about how they managed the conflict between their roles as caregivers and personal or family obligations. They are deemed “essential workers,” risking their safety to fulfill their duties. Objectives: This study aims to explore the lived experience of nurses during COVID-19 and wartime, delving deeper into their emotional and moral experiences, providing insights for nurses and nursing management about how nurses negotiate dilemmas. Methods: A focused interpretive, hermeneutic, phenomenological approach was employed. From December 2022 to January 2023, ten hospital-based nurses from two hospitals were purposively sampled for in-depth, semi-structured interviews, which were transcribed and analyzed. The study was approved by the University Ethics Committee (31102022). Results: The essence of “ Moral Conflicts of Dual Identity and Dual Allegiance” revealed profound moral and emotional struggles among nurses. Four key themes emerged: (1) Moral Stressors and Identity Negotiation, (2) Competing Responsibilities and Ethical Double-binds, (3) Virtual and Practical Wisdom in Crises, (4) Responses of Stress and Erosion of Support Conclusions: Understanding nurses’ ethical dilemmas is essential for healthcare leadership. Leaders must make it a priority for workplace safety for their nurses. In wartime, it is not obvious that the workplace is unsafe; leaders must foster open dialog and support systems in response to these crises. This study highlights the significance of peer support, emphasizing the need for policies that address the complex moral challenges nurses face daily. Full article

This scoping review examines public health communication across nine Eastern European and Central Asian states—Armenia, Azerbaijan, Belarus, Kazakhstan, Kyrgyzstan, Russia, Tajikistan, Turkmenistan, and Uzbekistan—highlighting how these systems have transitioned from Soviet-era legacies to contemporary practices. Eligibility criteria included the English- and Russian-language literature published from 1998 onwards, focusing on nine post-Soviet states. Sources of evidence comprised searches in Google Scholar, ScienceDirect, SSRN, Heliyon, MEDLINE/PubMed, and official government websites. Data were charted by three independent reviewers using a standardized form, with discrepancies resolved by senior reviewers. The review identifies persistent gaps in communication during health crises, with a particular focus on the COVID-19 pandemic, where centralized and hierarchical information flows often undermine transparency and responsiveness, as well as further increased health inequalities between rural and urban health outcomes. Despite ongoing reforms, the communication dimension of healthcare systems remains underdeveloped. Findings reveal that centralized and top-down communication remains a dominant feature across the region, hindering timely dissemination of information and limiting the capacity to counter misinformation, as both misinformation and disinformation sometimes emerge from the government. Ultimately, this review contributes a critical analysis of these systematic communication failures and underscores the need to strengthen public health communication and reduce health inequalities. To do it, governments must prioritize transparency, disclose decision-making processes, and rely on evidence-based messaging to build trust. Effective crisis response requires not only government leadership but also the active engagement of the medical and patient communities, supported by civil society and independent media. This review points out the need for more inclusive, transparent, and trust-oriented communication strategies to enhance public health preparedness and resilience in nine Eastern European and Central Asian contexts. Full article

Background: Emotional intelligence (EI), particularly the ability to regulate one’s emotions, is a key protective factor against stress and burnout in high-demand occupations, including leadership and healthcare. Compassion and gratitude practices have been proposed as brief, scalable methods to strengthen emotion regulation, yet empirical evidence from randomised controlled trials remains limited. Objective: This study evaluated whether a four-week, self-directed online programme combining daily loving-kindness meditation and gratitude journaling improves EI among leaders. Methods: Forty-five leaders in Germany from diverse occupational sectors were recruited via LinkedIn and Xing and were randomised using a computer-generated random sequence to an intervention or wait-list control group. EI was measured pre- and post-intervention with the Emotional Competence Questionnaire (EKF), comprising recognising one’s own feelings (RU), recognising others’ feelings (RO), regulating one’s own feelings (RC; primary outcome), and expressing feelings (RE). Adherence was reported in categorical form (e.g., daily, 3–5×/week, 1–2×/week). Treatment effects were tested using mixed-design ANOVAs. Results: A significant Group × Time interaction emerged for emotion regulation (RC), indicating greater improvement in the intervention group compared with the control group. No significant interaction effects were found for RU, RO, or RE. Adherence data did not permit dose–response analysis. Conclusions: A brief, self-directed online compassion and gratitude programme selectively improved emotion regulation—the EI facet most strongly linked to stress buffering and resilience. Although effects did not extend to other EI dimensions, findings suggest that low-threshold digital practices may strengthen a core emotional skill relevant to psychological well-being in leadership roles. Because the sample did not primarily comprise healthcare professionals, implications for healthcare settings re-main conceptual; targeted trials in clinical populations are warranted. Full article

Lack of leadership succession planning in South African public hospitals places nursing leadership at great risk instead of improving healthcare. There is a significant demand for nurse managers in the Free State Province; therefore, leadership succession planning is important. The re-advertising of unfilled leadership roles, the projected volume of nurse managers who will be retiring, and the number of professional nurses opting for better international opportunities indicate the need for effective succession planning. The study aims to determine leadership succession planning for professional nurses in a selected public hospital in the Mangaung District, Free State Province. A qualitative, explorative, and descriptive research design will be used. Non-probability purposive sampling will be adopted to explore the leadership succession planning. The research participants will consist of professional nurses who are currently permanently employed within the Mangaung district, Free State Province. The sample size will be determined by data saturation. An estimated sample size of ±20 participants will be expected. Data collection will be performed through in-depth, unstructured interviews to answer the research question. A central place for interviews will be organised, and appointments will be made with participants as per their schedule or availability. Data will be analysed using Braun and Clarke’s thematic method. The conclusion and the recommendations will be based on the findings of the study. Full article

Purpose: To describe structural and systemic barriers to ophthalmic care experienced by underserved patients, particularly those facing language obstacles, immigration-related constraints, limited insurance coverage, financial hardship, and navigation challenges in an urban setting, and to examine these barriers through a complexity-informed lens. Methods: We conducted a narrative literature review focused on healthcare disparities, patient navigation, complexity in care delivery, and time-sensitive prioritization frameworks in ophthalmology. Findings were integrated with case vignettes drawn from Eyes on Wheels (EOW), a mobile eye care initiative that provides no-cost examinations at Federally Qualified Health Centers (FQHCs) and free clinics. Cases were identified through routine clinical documentation and used to illustrate how structural barriers described in the literature manifest in real-world care pathways. Results: Three recurring system-level issues were identified across EOW encounters: (A) misclassification of medically necessary, time-sensitive ophthalmic care as “non-urgent”; (B) patient disengagement driven by cumulative structural and logistical barriers; and (C) failures that arise when the healthcare system, functioning as a complex adaptive system (CAS), is unable to adapt to patients’ and systems’ changing circumstances. A review of the literature confirmed that these patterns reflect widely documented challenges faced by underserved urban populations. Three EOW case vignettes, selected from seven patients identified in 2024, are presented as illustrative examples of these systemic patterns. Conclusions: Addressing inequities in eye care requires an approach that recognizes how many parts of the healthcare system interact and affect a patient’s ability to receive timely treatment. Vision loss is often the preventable result of systems that are rigid, fragmented, or unable to adapt to a patient’s circumstances. Improving outcomes will require flexible care models, such as mobile clinics, paired with strong institutional support, patient-centered navigation, and consistent assessment of social needs and barriers to care. Sustained progress will depend on collaboration across organizations, adaptable leadership, and policies that respond to the real-world situations in which patients live. Full article

Peer support has demonstrated efficacy in alleviating symptoms of anxiety and depression, while fostering empathy and mitigating burnout among healthcare professionals. Given the considerable demands of residency training, there is a strong rationale for resident-led peer support interventions. However, structured programs to train residents for such leadership roles remain limited. Our objective was to implement a peer support leader training program for residents, evaluate its perceived effectiveness, and identify common themes discussed in sessions. Between June 2021 and June 2023, we performed a longitudinal, prospective cohort survey study of Emergency Medicine (EM) and EM/Pediatrics (EM/P) residents participating in a novel peer support leader training curriculum. Resident peer support leaders then facilitated biweekly support sessions, with post-session surveys assessing leader preparedness and themes discussed utilizing a novel Resident Stress Checklist (RSC). In total, 16 unique leaders were trained over two years and 52 biweekly peer support group sessions were held. In Year 1 (Y1), 6 resident leaders conducted an average of three sessions each, with 7 residents on average attending each session. In Year 2 (Y2), 4 leaders graduated and 2 leaders from Y1 continued in this role. An additional 10 resident leaders were trained. The 12 leaders in Y2 facilitated an average of 2 sessions each, with 5 residents on average attending each session. Of the completed post-session leader surveys (n = 39), 100% reported feeling prepared to lead the sessions based on their training. The RSC identified the most frequent stressor as work–life balance, most common symptom as frustration, and most common consequence of stress as emotional/psychological suffering. Resident-led peer support training was feasible and well-received, with all surveyed resident leaders reporting adequate preparation. The RSC revealed common session themes that guided future training topics and wellness curriculum interventions. Full article

Tuberculosis (TB) remains a public health threat in low- and middle-income countries (LMICs) of the World Health Organization (WHO) Eastern Mediterranean Region (EMR), driven by a combination of social determinants including undernutrition, fragile health systems, conflict-related disruptions, human mobility and displacement, sub-optimal programmatic implementation, and insufficient domestic investment. These programmatic and governance constraints operate within a broader geopolitical context marked by conflict, sanctions, protracted crises, and large-scale displacement, which further limit countries’ ability to deliver uninterrupted TB services. In 2023, the region’s TB incidence was estimated at 116 per 100,000 population, with Pakistan alone accounting for about 73% of the regional burden. Despite a multitude of efforts, progress in reducing the TB burden in the EMR remains slow, with high case detection and treatment coverage gaps, low uptake of TB preventive treatment (TPT), underutilization of WHO-recommended rapid diagnostics, and only 25% of drug-resistant TB (DR-TB) cases initiated on treatment. Vulnerable populations, including internally displaced persons, migrants, refugees, prisoners, and returnees, continue to face major access barriers, and cross-border TB collaboration remains limited. This commentary reasons that the slow pace of TB burden reduction in the region is not only a biomedical or resource issue but also a reflection of structural and governance shortcomings. It proposes a ten-point strategic vision focused on building a sustainable ecosystem, enhancing primary healthcare systems, adopting people-centered and rights-based approaches, leveraging artificial intelligence, and gradually reducing dependency on external donors where feasible. However, in highly fragile settings such as Yemen or Somalia, domestic financing remains limited, and sustained external support will continue to be indispensable. The commentary calls for stronger national leadership, inclusive stakeholder engagement, and increased domestic financing to deliver integrated and resilient TB services. Ending TB in the EMR is within reach, but it requires boldly committed, coordinated, and country-led action. Full article

In response to persistent gaps in pain management competencies among nurses in Saudi Arabian teaching hospitals and similar healthcare settings globally, this manuscript presents a developed and validated action plan designed to support the effective transfer of pain management competencies into clinical practice. The action plan was developed to address the critical need for structured, practical strategies that enhance nurses’ ability to apply pain management knowledge in diverse interdisciplinary environments. The action plan was validated through a rigorous three-round e-Delphi technique involving 12 expert panel members, achieving a 75% consensus on its content and structure. The final validated plan includes clear action statements, implementation methods, designated responsibilities, and defined timeframes. The core action statements focus on the following: (i) motivating nurses to pursue further study; (ii) equipping nursing teams with appropriate pain management tools; (iii) developing content-specific, practice-oriented short training programs; (iv) tailoring training to accommodate different learning styles; (v) using diverse teaching methods; (vi) creating strategies to encourage participation in training; and (vii) promoting the application of acquired knowledge in clinical settings. Adoption and implementation of this action plan by nursing leadership are anticipated to significantly enhance the transfer of pain management competencies, ultimately improving patient outcomes. The plan is adaptable for use in similar healthcare settings worldwide, offering a replicable model for strengthening nursing practice through targeted competency development. Full article

Background: Unsafe care remains a major global health challenge, contributing to millions of preventable deaths and ranking among the top ten causes of mortality and disability worldwide. The World Health Organization’s Global Patient Safety Action Plan 2021–2030 emphasizes the need for strong leadership and system-wide engagement to eliminate avoidable harm. As the largest component of the global healthcare workforce, nurses—especially those in management roles—are essential to achieving these goals. Objective: This narrative review synthesizes global evidence on how nursing management practices, particularly leadership, staffing, and safety culture, influence patient safety outcomes across diverse health systems. Methods: A purposive narrative review was conducted using PubMed, CINAHL, Scopus, and Web of Science databases. Peer-reviewed studies and organizational reports published between 2020 and 2025 were evaluated. A thematic synthesis approach was used to identify patterns related to leadership style, staffing ratios, workplace conditions, and organizational resilience. Quality appraisal followed adapted Critical Appraisal Skills Programme (CASP) and Joanna Briggs Institute (JBI) guidance. Results: A total of 37 peer-reviewed empirical studies were included in the narrative synthesis, along with key global policy and foundational framework documents used to contextualize findings. Evidence consistently demonstrated that transformational leadership, adequate nurse staffing, positive safety culture, and organizational learning structures are strongly associated with improved patient outcomes, reduced errors, and enhanced workforce well-being. Most studies exhibited moderate to high methodological rigor. Conclusions: Nursing management plays a decisive role in advancing global patient safety. Policies that strengthen leadership capacity, ensure safe staffing, promote just culture, and support nurse well-being are critical to achieving WHO’s 2030 safety objectives. Empowering nurse leaders across all regions is essential for building safer, more resilient health systems. Full article