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The future increase of chronic diseases in the world requires new challenges in the health domain to improve patients' care from the point of view of the organizational processes, clinical pathways and technological solutions of digital health. For this reason, the present paper aims to focus on the study and application of well-known clinical practices and efficient organizational approaches through an innovative model (TALIsMAn) to support new care process redesign and digitalization for chronic patients.

In addition to specific clinical models employed to manage chronic conditions such as the Population Health Management and Chronic Care Model, we introduce a Business Process Management methodology implementation supported by a set of e-health technologies, in order to manage Care Pathways (CPs) digitalization and procedures improvement.

This study shows that telemedicine services with advanced devices and technologies are not enough to provide significant changes in the healthcare sector if other key aspects such as health processes, organizational systems, interactions between actors and responsibilities are not considered and improved. Therefore, new clinical models and organizational approaches are necessary together with a deep technological change, otherwise, theoretical benefits given by telemedicine services, which often employ advanced Information and Communication Technology (ICT) systems and devices, may not be translated into effective enhancements. They are obtained not only through the implementation of single telemedicine services, but integrating them in a wider digital ecosystem, where clinicians are supported in different clinical steps they have to perform.

The present work defines a novel methodological framework based on organizational, clinical and technological innovation, in order to redesign the territorial care for people with chronic diseases. This innovative ecosystem applied in the Italian research project TALIsMAn is based on the concept of a continuum of care and digitalization of CPs supported by Business Process Management System and telemedicine services. The main goal is to organize the different socio-medical activities in a unique and integrated IT system that should be sustainable, scalable and replicable.

This article aims to address the need for a more structured partnership between civilian and military healthcare, particularly in the context of cross-border threats in the EU. While both systems are driven by the same goal of providing high-quality healthcare services and achieving optimal patient outcomes, they operate under different national approaches and resources.

Two recent crises are presented as examples that highlight the necessity of cooperation between civilian and military medical systems. The Covid-19 Pandemic and the Ukrainian Conflict are described based on the experience gathered by the author as a member of the NATO Centre of Excellence for Military Medicine and form the base to shape a broader perspective on the future of civil-military interaction in healthcare at the European Union level.

The ability to deliver coordinated responses during crises depend on the level of interoperability, preparation and mutual understanding. To improve synergies, a structured partnership should be established, prioritizing common standards of care and shared best practices. Integrating military and civilian healthcare pathways can be especially beneficial in situations where patients are moved from the point of injury or sickness across different military and civilian structures to receive the most appropriate treatment and rehabilitation for their conditions.

The relationship between military and civilian healthcare systems is often discussed at multinational level, but a clear focus is lacking concerning their shared mission, distinct functions and potential for cross-border collaboration.

Climate change is one of our time’s most pressing global environmental challenges, and environmental innovation is critical to addressing it. This study aims to investigate the relationship between environmental innovation and carbon emission in the healthcare industry in Europe while also examining the moderating role of environmental governance.

Data for this study were collected from publicly listed healthcare companies in ten European countries spanning the years 2012–2021. The selected countries encompassed Belgium, Denmark, France, Germany, Italy, Netherlands, Spain, Sweden, Switzerland and the United Kingdom. The research encompassed all healthcare companies for which data were accessible, resulting in a comprehensive dataset comprising 1,210 companies. The authors collected data from multiple sources, including annual reports, the World Bank and Eikon databases, to ensure a robust and extensive dataset.

The results of this study indicate that environmental governance plays a significant moderating role in the relationship between environmental innovation and carbon emission within the healthcare sector in Europe, but when combined with high levels of environmental innovation, strong environmental governance leads to enhanced efforts to reduce carbon emissions. This combination also contributes to meeting the expectations of a broader range of stakeholders and maintaining legitimacy.

The study’s findings have practical implications for healthcare regulators, policymakers and various stakeholders. It underscores the importance of integrating solid environmental governance and innovation to address climate change challenges in the healthcare sector effectively. This integrated approach not only helps reduce carbon emissions but also contributes to achieving sustainable outcomes while satisfying a wider range of stakeholders.

This study adds to the existing body of knowledge by highlighting the significant role of environmental governance as a moderator in the relationship between environmental innovation and carbon emission in the healthcare industry. The research findings provide valuable insights for academics, practitioners and decision-makers, emphasizing the need to combine governance and innovation for sustainable outcomes in healthcare sectors.

The lean startup approach (LSA) is extensively utilized by early-stage entrepreneurs, with “pivot” serving as a key pillar. However, there is a research gap concerning the boundary conditions impacting LSA and pivot decisions, especially when addressing societal challenges, as in the context of transformational entrepreneurship. In this regard, the healthcare sector, further compounded by a lack of research on startups and scale-ups, presents an embraced opportunity to provide multiple contributions for both theory and practice.

The present investigation employs a grounded approach to explore the experiences of the co-founders of a fast-growing Italian e-health startup. A narrative strategy was employed to organize conditions and evolving strategic action/interactions into three different pivoting phases of the startup – before the pivot, its enactment and aftermath – with primary and secondary data collected over a period of one year.

Pivoting in digital healthcare unfolded as a liminal experience marked by factors such as high regulation, multiple stakeholders, technological and symbolic ambivalence, resource-intensive demands and institutional actors acting as pathway pioneers, leading to an information overload and unforeseeable uncertainty to manage. These factors challenge entrepreneurs' ability to attain optimal distinctiveness, presenting the paradoxical need for vertical flexibility for scaling up.

By uniquely illuminating the sector’s constraints on entrepreneurial phenomena, this study provides a valuable guide for entrepreneurs and institutional actors in addressing societal challenges.

This study introduces a process model of transformational information crafting when pivoting, highlighting the role of entrepreneurs' transformational stance and platform-mediated solutions as engines behind strategies involving information breaking and transition, preceding knowledge-driven integration strategies.

Research has established the prevalence and relevance of moral injury in healthcare workers, though less attention has been paid to the different classes of potentially morally injurious events (PMIEs) experienced by this population and their impact. This exploratory study sought to examine the frequency of self- and other-generated PMIE classes and their associations with demographic characteristics and well-being outcomes among mental healthcare staff.

Secondary analysis of data drawn from two cross-sectional surveys of 267 frontline and leadership staff from mental healthcare settings in the UK was conducted. Responses on the Moral Injury Events Scale and the Short Professional Quality of Life Scale were extracted for analysis.

Betrayal by others was most frequently endorsed (61.8%), whilst self-transgressions were least frequently reported (25.5%). After controlling for the number of PMIE classes experienced, betrayal significantly predicted secondary traumatic stress (p = 0.01) and burnout (p = 0.04). Additionally, other transgressions significantly predicted secondary traumatic stress (p = 0.008). The predictive effects of self-transgressions on burnout, secondary traumatic stress and compassion satisfaction were all nonsignificant after controlling for the number of PMIE classes experienced.

Findings highlight differences in the frequency and impact of self and other PMIEs experienced by healthcare professionals. Reducing cumulative exposure to differential PMIE classes appears to be of critical importance to improving occupational well-being in this group.

To our knowledge, this study is the first to explore the associations between PMIE classes and occupational well-being in a mental healthcare population, inclusive of frontline and leadership staff.

The purpose of this study is to identify organisational homeostasis factors in the context of healthcare organisations and to develop a conceptual model for green transformation.

The organisational homeostasis factors were determined by review of literature study and the opinions of healthcare experts. Scheduled interviews and closed-ended questionnaires are employed to collect data for this research. This study employed “TISM methodology” and “MICMAC analysis” to better comprehend how the components interact with one another and prioritise them based on their driving and dependence power.

This study identified 10 factors of organisational homeostasis in healthcare organisation. Recognition of interdependence, hormesis, strategic coalignment, consciousness on dependence of healthcare resources and cybernetic principle of regulations are the driving or key factors of this study.

The study's primary focus was on the organisational homeostasis factors in healthcare organisations. The methodological approach and structural model are used in a healthcare organisation; in the future, these approaches can be applied to other industries as well.

The key drivers of organisational homeostasis and the identified factors will be better comprehended and understood by academic and important stakeholders in healthcare organisations. Prioritizing the factors helps the policymakers to comprehend the organisational homeostasis for green transformation in healthcare.

In this study, the TISM and MICMAC analysis for healthcare is proposed as an innovative approach to address the organisational homeostasis concept in the context of green transformation in healthcare organisations.

Digital healthcare manages to grab considerable attention from people and practitioners to avoid severity and provide quick access to healthcare. Entrepreneurs also adopt the digital healthcare segment as an opportunity; nevertheless, their intentions to participate and encourage innovation in this growing sector are unexplored. Drawing upon the social capital theory and health belief model, the study examines the factors that drive entrepreneurship. A novel model is proposed to comprehend entrepreneurial intentions and behavior entrenched in social capital and other encouraging and dissuading perceptive elements with the moderation of trust in digitalization and entrepreneurial efficacy.

The cross-sectional method is used to collect data through a questionnaire from experienced respondents in China. The valid data comprises 280 respondents, analyzed by partial least square structural equation modeling.

Social capital significantly influences monetary attitude, and perceived risk and holds an inconsequential association with perceived usefulness, whereas monetary attitude and perceived usefulness meaningfully explain entrepreneurial activities. Perceived risk has a trivial impact on entrepreneurial intention. Entrepreneurial efficacy and trust in digitalization significantly explain entrepreneurial behavior and moderate the positive relationship between intention and behavior.

The present research proposes a novel research model in the context of entrepreneurship rooted in a digitalized world and offering new correlates. It provides valuable insights by exploring entrepreneurial motivation and deterring factors to get involved in startup activities entrenched in social capital, providing guidelines for policymakers and practitioners to promote entrepreneurship.

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.

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.

Health-care marketing typically entails a coordinated set of outreach and communications designed to attract consumers (patients in the health-care context) who require services for a better health outcome and guide them throughout their health-care journey to achieve a higher quality of life. The purpose of this study is to understand the progress and trends in healthcare marketing strategy (HMS) literature between 2018 and 2022, with a special emphasis on the pre- and post-Covid-19 periods.

The authors examine 885 HMS-related documents from the WOS database between 2018 and 2022 that were extracted using a keyword-based search strategy. After that, the authors present the descriptive statistics related to the corpus. Finally, the authors use author co-citation analysis (ACA) and bibliographic coupling (BC) techniques to examine the corpus.

The authors present the descriptive statistics as research themes, emerging sub-research areas, leading journals, organisations, funding agencies and nations. Further, the bibliometric analysis reveals the existence of five thematic clusters: Cluster 1: macroeconomic and demographic determinants of healthcare service delivery; Cluster 2: strategies in healthcare marketing; Cluster 3: socioeconomics in healthcare service delivery; Cluster 4: data analytics and healthcare service delivery; Cluster 5: healthcare product and process innovations.

This study provides an in-depth analysis of the advancements made in HMS-related research between 2018 and 2022. In addition, this study describes the evolution of research in this field from before to after the Covid-19 pandemic. The findings of this study have both research and practical significance.

To the best of the authors’ knowledge, this is the first study of its kind to use bibliometric analysis to identify advancements and trends in HMS-related research and to examine the pattern before and after Covid-19 pandemic.