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The purpose of this study was to better understand the state of the healthcare facility management (FM) workforce and trends and how it compares to the nonhealthcare industries.

A survey was developed, based on relevant literature, regarding respondents’ gender, race, age, educational attainment and job tenure. The survey was sent electronically via Qualtrics^® system in February 2021 to members of the International Facility Management Association membership; 3,557 individuals completed the survey by April 2021, for a 29% response rate. Only data from 1,407 US respondents working in facility operations were included in this study. Of the 1,407 respondents included in this study, 89 worked in the healthcare industry. The majority of respondents not working in healthcare industry (1,318) were employed in government, education or banking and investment.

The demographics of facility managers in the healthcare industry are similar to the demographics of facility managers in other industries: the majority of the FM workforce is male, middle-aged, white, college educated and employed in-house. While healthcare and nonhealthcare facility managers have similar responsibilities across job levels, compensation for entry-level FM roles in the healthcare industry is significantly lower than for entry-level FM roles in other industries. This low pay in healthcare FM, compared to other industries, may exacerbate ongoing challenges related to talent recruitment and retention and justify pay banding increases to improve attraction of top talent into healthcare FM. Both healthcare and nonhealthcare industries hire new college graduates for entry-level FM jobs, but the healthcare industry is more likely to hire individuals who majored in liberal arts compared to other industries more likely to hire individuals who majored in subjects related to the built environment such as FM and engineering. To compensate for low entry-level pay, healthcare organizations may be focusing recruitment efforts on liberal arts students who have little to no training in the built environment because they have lower pay expectations. Older healthcare facility professionals also have shorter job tenures with their current employers than do older facility professionals in other industries; this trend appears to be recent and not be related to pay or the COVID-19 pandemic. A surge of senior-level FM retirements may be creating advancement opportunities for older entry- and mid-level FM personnel in healthcare; if this situation is a factor, research should be conducted to understand its implications for recruiting and developing healthcare FM talent.

Only data from US respondents who were working in healthcare facility operations at the time of the study were included in the data analysis.

Healthcare organizations can use the study’s findings to help address FM workforce challenges unique to their industry staff recruitment, retention and succession planning.

Healthcare providers are under pressure due to increasing and more complex demands for services. Increased pressure on budgets and human resources adds to an ever-growing problem set. Competent leaders are in demand to ensure effective and well-performing healthcare organisations that deliver balanced results and high-quality services. Researchers have made significant efforts to identify and define determining competencies for healthcare leadership. Broad terms such as competence are, however, inherently at risk of becoming too generic to add analytical value. The purpose of this study is to suggest a holistic framework for understanding healthcare leadership competence, that can be crucial for operationalising important healthcare leadership competencies for researchers, decision-makers as well as practitioners.

In the present study, a critical interpretive synthesis (CIS) was conducted to analyse competency descriptions for healthcare leaders. The descriptions were retrieved from peer reviewed empirical studies published between 2010 and 2022 that aimed to identify healthcare services leadership competencies. Grounded theory was utilised to code the data and inductively develop new categories of healthcare leadership competencies. The categorisation was then analysed to suggest a holistic framework for healthcare leadership competence.

Forty-one papers were included in the review. Coding and analysing the competence descriptions resulted in 12 healthcare leadership competence categories: (1) character, (2) interpersonal relations, (3) leadership, (4) professionalism, (5) soft HRM, (6) management, (7) organisational knowledge, (8) technology, (9) knowledge of the healthcare environment, (10) change and innovation, (11) knowledge transformation and (12) boundary spanning. Based on this result, a holistic framework for understanding and analysing healthcare services leadership competencies was suggested. This framework suggests that the 12 categories of healthcare leadership competencies include a range of knowledge, skills and abilities that can be understood across the dimension personal – and technical, and organisational internal and – external competencies.

This literature review was conducted with the results of searching only two electronic databases. Because of this, there is a chance that there exist empirical studies that could have added to the development of the competence categories or could have contradicted some of the descriptions used in this analysis that were assessed as quite harmonised. A CIS also opens for a broader search, including the grey literature, books, policy documents and so on, but this study was limited to peer-reviewed empirical studies. This limitation could also have affected the result, as complex phenomenon such as competence might have been disclosed in greater details in, for example, books.

The holistic framework for healthcare leadership competences offers a common understanding of a “fuzzy” concept such as competence and can be used to identify specific competency needs in healthcare organisations, to develop strategic competency plans and educational programmes for healthcare leaders.

This study reveals a lack of consensus regarding the use and understanding of the concept of competence, and that key competencies addressed in the included papers are described vastly different in terms of what knowledge, skills and abilities they entail. This challenges the operationalisation of healthcare services leadership competencies. The proposed framework for healthcare services leadership competencies offers a common understanding of work-related competencies and a possibility to analyse key leadership competencies based on a holistic framework.

Purpose – This paper seeks to look at healthcare service quality from the viewpoint of its negative impact on the industry when there is a deficiency in the delivery of service quality. To measure this impact, the potential loss of customers due to poor quality service is measured. A potential customer loss model is proposed. To address the competitive and financially driven healthcare delivery business, a three‐pillar approach, termed the Excellent Healthcare Service Model (EHSM), is introduced. This approach advocates that the healthcare industry should use a system view to deliver quality healthcare by taking into account quality, cost, and efficiency factors in a holistic manner. Design/methodology/approach – In this paper a survey questionnaire was used to gather data necessary to compute impact of deficient healthcare service. The questionnaire was administered to a sample of 400 people and the survey method used was intercept interview. Customer loss and potential customer loss due to deficient service were computed. Findings – In this paper, findings from the research indicated that, in the healthcare industry, for every 100 customers that experienced deficient service, about 70 customers would be unlikely to patronize the same organization again. In addition, for the same 100 customers who have experienced deficient service, about 75 of them will go on to tell on average nine family members and friends about their experiences. Through word of mouth from these 75 dissatisfied customers, there will eventually be about 465 persons who might have been potential customers but will probably not patronize the organization at all based on what the dissatisfied customers have told them. Practical implications – The ideas presented in this paper provide a new way of looking at service quality performance, through the impact of deficient service. With this knowledge, economic impacts of poor service quality could easily be quantified, and such economic‐based results are usually a better motivator for managers and workers to deploy quality improvement initiatives. Originality/value – The results and ideas presented in this paper are valuable for the healthcare industry. It provides an alternative approach to quantify service quality performance. The paper also proposes a system‐based approach to enhance service process performance.

The purpose of this paper is to develop a framework for the improvement of healthcare services through an effective human resource management system. The case study highlights a need to analyze human resource management processes that exist in healthcare sector and suggests better ways to achieve higher levels of patient satisfaction.

The methodology consists of first developing a conceptual framework for human resource management in healthcare industry. The proposed framework comprises of three parts: inputs which include determining employee competencies, HR planning, job analysis, recruitment, selection, compensation benefits, pay/rewards, labor and employee relations; processes (training and development) focus on healthcare systems; and outputs which include quality, cost, technology, and responsiveness leading to patient satisfaction. Then, the framework has been studied with help of a case study conducted in a hospital in India.

The most important skill required for healthcare workforce to deliver high-quality care to patients is the human resource development. By appropriate workforce development, healthcare organizations can provide high-quality services to patients. Finally, it derives a set of conclusions from the case study research. Further research would be needed to validate the framework through empirical data.

This research is a new attempt as there is a limited research done earlier on the framework of human resource management in healthcare system and services. It is designed to facilitate training and development at both the individual and at organizational levels, advocating a balance between “healthcare employee” and “healthcare system.”

The purpose of this research study was to obtain healthcare executives’ perspectives on diversity in executive healthcare leadership. The study focused on identifying perspectives about diversity and its potential impact on the access of healthcare services by people of color. The study also identified perspectives about factors that influence the attainment of executive healthcare roles by people of color.

A convenience sample of healthcare executives was obtained. The executives identified themselves as belonging to one of two subgroups, White healthcare executives or executives of color. Participants were interviewed telephonically in a semi-structured format. The interviews were transcribed and entered into a qualitative software application. The data were codified and important themes were identified.

The majority of the study participants perceive that diversity of the executive healthcare leadership team is important. There were differences in perspective among the subgroups as it relates to solutions to improve access to healthcare by people of color. There were also differences in perspective among the subgroups, as it relates to explaining the underrepresentation of people of color in executive healthcare leadership roles.

This research effort benefited from the subject matter expertise of 24 healthcare executives from two states. Expansion of the number of survey participants and broadening the geographical spread of where participants were located may have yielded more convergence and/or more divergence in perspectives about key topics.

The findings from this research study serve to add to the existing body of literature on diversity in executive healthcare leadership. The findings expand on the importance of key elements in contemporary literature such as diversity, cultural competency and perspectives about the need for representation of people of color in leadership roles that guide healthcare policy and access. This study connects contemporary literature to perspectives of executives in the field and offers practical solutions to improving the representation of people of color in executive healthcare leadership roles.

The recommendations offered as a result of this research effort serve to create awareness of the challenges that people of color face in career attainment. Although the process of increasing the representation of people of color in executive healthcare leadership will be a complex task that will involve a number of players over the course of several years, this study serves to provide a practical roadmap with actionable tactics that can be deployed.

This paper is an extension of the work that was done by the author during the course of completing the program requirements for the author’s doctoral program. The findings were previously discussed in the author’s dissertation. The value of these findings is significant because they validate some of the topics in contemporary literature with the perspectives of practicing healthcare executives. This study is also unique from other studies in that it offers a long-term plan to increase the representation of people of color in executive roles by creating an early disposition toward executive level roles and identifies a number of practical steps toward that end.

Competition rules maximise consumer welfare by promoting efficient use of scarce resource and thus high output, low prices, high quality, varied services, innovation, production and distribution. European courts consider doctors and hospital staff as undertakings (any entity that performs economic activities), so that if they enter into agreements then they have to comply with competition rules. This paper's objective is to determine whether competition law, which applies to undertakings, can in fact be applied to different healthcare‐sector players and whether specific rules are needed regarding competition between healthcare undertakings.

Data were selected from relevant European and national case law, European institution legal documents (such as regulations, guidelines and communications) and healthcare competition law literature, and then examined.

The paper finds that competition rules are applicable to healthcare players considering the consequences if competition rules are applied to the healthcare market. For market processes to result in the appropriate cost, quality and output, competition law must be proactive. In other words, quality must be fully factored into the competitive mix, allowing consumers to weigh healthcare price and non‐price characteristics.

Countries have different healthcare system and competition rules (although similar), competition rule impact is different for each country. Some healthcare systems are more regulated and there will be less opportunity for healthcare players to compete.

Efficiently applying competition law to healthcare players means that several challenges need facing, such as healthcare quality complexity and court scepticism.

This article points out the challenges when competition law is applied to the healthcare sector and how these challenges are faced in certain countries such as The Netherlands.

Currently the healthcare industry in the US is not only contending with relentless pressures to lower costs while maintaining and increasing the quality of service but is also under a stringent timeline to become compliant with the health insurance, portability and accountability act (HIPAA) regulatory requirements. Robust healthcare information systems (HCIS) become critical to enabling healthcare organizations address these challenges. Hence, it becomes an imperative need that the information that is captured, generated and disseminated by these HCIS be of the highest possible integrity and quality as well as compliant with regulatory requirements. This paper addresses this need by proposing an integrative framework for HIPAA compliant, I*IQ HCIS. It bases this framework on an integration of the requirements for HIPAA compliance, the principles of information integrity, as well as the healthcare quality aims set forth by the Committee on the Quality of Healthcare in America.

One of the most important instruments for gathering information and processing data relating to professional and organisational quality in health systems is “healthcare processes classification”. The authors found that a typical problem of many European countries is a lack of reliable information in the field of healthcare, mainly because the development of quality instruments, including healthcare processes classification, is not a priority for medical and other health professions. Additionally, it is difficult to update this instrument coherently with organisational changes and developmental achievements. This article describes the approach used by the University Medical Centre in Ljubjana, Slovenia, to redesign its healthcare processes classification in order to improve the quality of healthcare.

Theory of Constraints (TOC), though a well-established process improvement methodology in manufacturing, is still a novel philosophy for healthcare and an exhaustive review of literature is needed to summarize the key findings of various researchers. Such a review can provide a direction to the researchers and academicians interested in exploring the application of TOC in the healthcare sector. This paper aims to review the existing literature of TOC tools and techniques applied to the healthcare environment, and to investigate motivating factors, benefits and key gaps for identifying directions for future research in the domain of healthcare.

In this paper, different electronic repositories were searched using multiple keywords. The current study identified 36 articles published between January 1999 to mid-2021 to conceptualize and summarize the research questions used in the study. Descriptive analysis along with pictorial representations have been used for better visualization of work.

This paper presents a thorough literature review of TOC in healthcare and identifies the evolution, current trends, tools used, nature of services chosen for application and research gaps and recommends future direction for research. A variety of motivating factors and benefits of TOC in healthcare are identified. Another key finding of this study is that almost all implementations listed in literature reported positive outcomes and substantial improvements in the performance of the healthcare unit chosen for study.

This paper provides valuable insight to researchers, practitioners and policymakers on the potential of TOC to improve quality of services, flow of patients, revenues, process efficiency and cost reduction in different health care settings. A number of findings and suggestions compiled in the paper from literature study can be used for diagnosing, learning and making substantial changes in healthcare. The methodologies used by different researchers were analysed and combined to propose a generic step by step procedure to apply TOC. This methodology will guide the practising managers about the appropriate tools of TOC for their specific need.

Good health is always the first desire of all men and women around the globe. The global aim of healthcare is to quickly cure more patients and ensure healthier population both today and in future. This article will work as a foundation for future applications of TOC in healthcare and guide upcoming applications in the booming healthcare sector. The paper will help the healthcare managers in serving a greater number of patients with limited available resources.

This paper provides original collaborative work compiled by the authors. Since no comprehensive systematic review of TOC in healthcare has been reported earlier, this study would be a valuable asset for researchers in this field. A model has been presented that links various benefits with one another and clarifies the need to focus on process improvement which naturally results in these benefits. Similarly, a model has been presented to guide the users in implementation of TOC in healthcare.

Green transformation is more than simply a trend; it is a way of life, a set of habits, a field of knowledge and a dedication to resource conservation. Going green is surely a creative and transformative process for both individuals and organizations. This paper aims to “identify,” “analyse” and “categorise” the readiness factors for green transformation process in health care using total interpretive structural modelling (TISM) and neutrosophic-MICMAC.

To address the study objectives, the study used TISM and neutrosophic-MICMAC analysis. To identify the readiness factors, a literature study was conducted, and the factors were face-validated by the healthcare experts. The factors influence on one another were captured by using a scheduled interview with a closed ended questionnaire. The TISM addressed the identification and analysing of factors and the categorization and ranking the readiness factors is addressed by using neutrosophic-MICMAC analysis.

This study identified 11 green transformation process readiness factors for healthcare organizations. The study states that the key factors or driving factors are awareness of green governance principle, environment leadership and management, green gap analysis, information and communication technology and innovation dynamics.

The factor ranking is sensitive to the respondents’ ratings. The study relied on the past literature and experts’ opinion may result in the subjective biases. The complex nature of healthcare ecosystem challenges to capture all the factors. The study focussed on Indian hospitals.

Study significantly impacts the healthcare practitioners, academicians and policymakers by providing critical insights into the readiness factors required for the healthcare green transformation process. The study offers a better understanding of the crucial or key or driving factors that aid in embracing green and sustainable practices.

Identifying a gap in conceptual and theoretical frameworks for green transformation readiness factors in healthcare organizations and in Indian context. The study addresses this gap by aiming to create a thorough theoretical framework and highlighted by its focus on Indian hospitals.