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BACKGROUND: Healthcare professionals' job satisfaction is a critical indicator of healthcare performance, pivotal in addressing challenges such as hospital quality outcomes, patient satisfaction, and staff retention rates. Existing evidence underscores the significant influence of healthcare leadership on job satisfaction. Our study aims to assess the impact of leadership support on the satisfaction of healthcare professionals, including physicians, nurses, and administrative staff, in China's leading hospitals. METHODS: A cross-sectional survey study was conducted on healthcare professionals in three leading hospitals in China from July to December 2021. These hospitals represent three regions in China with varying levels of social and economic development, one in the eastern region, one in the central region, and the third in the western region. Within each hospital, we employed a convenience sampling method to conduct a questionnaire survey involving 487 healthcare professionals. We assessed perceived leadership support across five dimensions: resource support, environmental support, decision support, research support, and innovation encouragement. Simultaneously, we measured satisfaction using the MSQ among healthcare professionals. RESULTS: The overall satisfaction rate among surveyed healthcare professionals was 74.33%. Our study revealed significant support from senior leadership in hospitals for encouraging research (96.92%), inspiring innovation (96.30%), and fostering a positive work environment (93.63%). However, lower levels of support were perceived in decision-making (81.72%) and resource allocation (80.08%). Using binary logistic regression with satisfaction as the dependent variable and healthcare professionals' perceived leadership support, hospital origin, job role, department, gender, age, education level, and professional designation as independent variables, the results indicated that support in resource provision (OR: 4.312, 95% CI: 2.412 ∼ 7.710) and environmental facilitation (OR: 4.052, 95% CI: 1.134 ∼ 14.471) significantly enhances healthcare personnel satisfaction. CONCLUSION: The findings underscore the critical role of leadership support in enhancing job satisfaction among healthcare professionals. For hospital administrators and policymakers, the study highlights the need to focus on three key dimensions: providing adequate resources, creating a supportive environment, and involving healthcare professionals in decision-making processes.

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Substantial evidence indicates that leadership plays a critical role in an organization's success. Our study aims to conduct case studies on leadership attributes among China's five top-performing hospitals, examining their common practices. A semi-structured interview was conducted with 8 leaders, 39 managers, 19 doctors, and 16 nurses from the five sample hospitals in China. We collected information from these hospitals on the role of senior leadership, organizational governance, and social responsibility, aligning with the leadership assessment guidelines in the Baldrige Excellence Framework. Qualitative data underwent interpretation through content analysis, thematic analysis, and comparative analysis. This study adhered to the consolidated criteria for reporting qualitative research guidelines for reporting qualitative research. Our study revealed that the leaders of the five top-performing hospitals in China consistently established "Patient Needs First" as the core element of the hospital culture. Striving to build world-renowned hospitals with Chinese characteristics, the interviewees all believed strongly in scientific vigor, professionalism, and cooperative culture. The leaders adhered to a staff-centered approach, placing special emphasis on talent recruitment and development, creating a compensation system, and fostering a supportive environment conducive to enhancing medical knowledge, skills, and professional ethics. In terms of organizational governance, they continuously enhanced the communication between various departments and levels of staff, improved the quality and safety of medical care, and focused on innovative medical and scientific research, thereby establishing evidence-based, standardized hospital management with a feedback loop. Meanwhile, regarding social responsibility, they prioritized improvements in the quality of healthcare by providing international and domestic medical assistance, community outreach, and other programs. To a large extent, the excellent leadership of China's top-performing hospitals can be attributed to their commitment to a "Two-Pillared Hospital Culture," which prioritizes putting patient needs first and adopting a staff-centered approach. Furthermore, the leaders of these hospitals emphasize hospital performance, operations management, and social responsibility.

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Participation of main users in identifying key performance indicators (KPIs) for management dashboards contributes to their success. The aim of this study was to identify and prioritize the KPIs of hospital management dashboards from the viewpoint of hospital managers. This study was conducted on managers of public hospitals at a national level in Iran in 2020. Data were collected using a self-administrated questionnaire. The KPIs were classified into five categories, namely financial, operational, human resources, safety and quality of care, services provided to patients. A total of 234 hospital managers participated in this study. Totally, 25 KPIs were determined for the hospital management dashboard, including the patient falls rate, waiting time for patients in the emergency department, patient satisfaction, total hospital revenue, financial balance, bed occupancy rate, patients' discharge with own agreement, average length of stay, and personnel satisfaction. For designing hospital management dashboards, the domains of services provided to patients, safety and quality of care, financial resources, human resources, and operational are important from the hospital managers' viewpoint, respectively. The results of this study can be helpful for developers of business intelligence tools, such as hospital management dashboards, to visualize the most important indicators for managers.

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PURPOSE: The purpose of this study is to identify the leadership characteristics that make a health-care organization ready for lean implementation, analyse the interdependence among them and determine the rank of each characteristic based on their influence in the overall phenomenon. DESIGN/METHODOLOGY/APPROACH: The leadership characteristics were identified through a review followed by an expert interview. Then, total interpretive structural modelling (TISM) was used to analyse the interdependence and determine the rank, driving power and dependence of each characteristic. FINDINGS: The results suggest that modesty is the most crucial leadership characteristic that makes a health-care organization ready for the successful incorporation of lean practices. Apart from that, attributes such as transparency, accountability, a leader's ability to empower the employees and communication play a significant role in making the change management programme impactful and effective. A leader's team building capacity was found to be the dependent characteristic and was ranked the last in the overall phenomenon. RESEARCH LIMITATIONS/IMPLICATIONS: Though this study throws light on various leadership dispositions that prepare a health-care organization to become a lean, it is still not an exhaustive exploration to be generalized. Because the leadership characteristics required for successful lean implementation may vary from one organization to the other depending on the purpose, intensity and priority of the implementation programme, these parameters along with the complexity of the scenario would determine what other leadership characteristics need to be included in the model to make it more robust and holistic. ORIGINALITY/VALUE: The novelty of the study lies in capturing the leadership characteristics for organizational readiness in the health-care sector and using the TISM approach to identify the critical characteristics in the context of lean implementation in hospitals.

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Background: Earlier surveys have reported a lack of representation of women in hospital leadership positions. This study sought to investigate the proportion of women in senior hospital leadership positions and to investigate whether hospital and community factors are associated with the likelihood of having women in executive positions. Methods: The main data of 4397 hospitals were sourced from the American Hospital Association. The study calculated the proportion of women for each position, with county-level adjusted standard errors and logistic transformed confidence intervals to determine the variation of women in chief officer positions across hospitals. The study also used multilevel mixed-effects logistic regressions to estimate the probability of having a female chief officer. Results: Women executives generally were underrepresented in all positions except in chief human resources and chief nursing officer positions, 73% (95% confidence interval [CI] 7175) and 91% (95% CI 8694), respectively. Women accounted for 13% (95% CI 821) of system chief executive officers (CEOs) and only 27% (95% CI 2628) of hospital CEOs. System size (number of hospitals) and hospital size (beds capacity) variables were statistically significant in five of the eight positions investigated. Overall, women were less likely to hold chief positions in large hospitals (400 beds and over) compared to small hospitals (under 100 beds). Conclusion: Women were underrepresented in hospital top positions and were less likely to hold executive positions in large systems or hospitals. The results suggest structural barriers that hinder women from advancing to top hospital positions.

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BACKGROUND: As the drug poisoning crisis worsens in North America and opioid use disorder (OUD)-related hospital admissions increase, policymakers and hospital administrators are beginning to recognize the important role of hospitals in the OUD care continuum. This study explores and describes how U.S. addiction medicine physicians created and presented business propositions to hospital administrators to support the development of addiction medicine consult (AMC) services. METHODS: Fifteen qualitative interviews were completed with board-certified or board-eligible addiction medicine physicians from 14 U.S. hospitals. The interviews occurred as part of a broader mixed methods study exploring hospital service delivery for patients admitted with OUD. Using a directed content analysis, the transcribed interviews were coded, analyzed, and final themes consolidated. RESULTS: Semi-structured interviews completed with addiction medicine physicians from established (n = 9) and developing (n = 5) AMC services at 14 U.S. hospitals explored how clinical champions persuaded hospital administrators to support AMC service development. Four elements were foundational to making the "business case": 1) describing the prevalence of substance use disorder (SUD) or OUD in the hospital; 2) identifying the negative financial impacts of not treating SUDs during hospitalization; 3) highlighting the ongoing care quality and treatment gap for hospitalized patients with SUDs; and 4) noting the success of other institutional AMC services. Study findings informed the creation of tools to support AMC service development: 1) an AMC service business case template, and 2) an AMC service design and operations resource list. CONCLUSIONS: OUD-related hospital admissions are unlikely to abate. Hospital administrators should consider innovative care delivery mechanisms to improve care for persons with OUD. AMC services may be a promising delivery mechanism to achieve this aim. For clinical and administrative champions, understanding how to communicate the potential effectiveness of this intervention to hospital leaders is an essential first step to AMC service creation.

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BACKGROUND: Our institution continued to experience a hyperendemic situation with carbapenem-resistant Acinetobacter baumannii despite a bundle of interventions. We aim to describe the effect of the subsequent implementation of electronic dissemination of the weekly findings of a bundle of interventions. METHODS: This was a quasiexperimental study performed at a 1,500-bed, public, teaching hospital. From January 2011 to March 2012, weekly electronic communications were sent to the hospital leadership and intensive care units (ICUs). These communications aimed to describe, interpret, and package the findings of the previous week's active surveillance cultures, environmental cultures, environmental disinfection, and hand cultures. Additionally, action plans based on these findings were shared with recipients. RESULTS: During 42 months and 1,103,900 patient-days, we detected 438 new acquisitions of carbapenem-resistant A baumannii. Hospital wide, the rate of acquisition decreased from 5.13 ± 0.39 to 1.93 ± 0.23 per 10,000 patient-days, during the baseline and postintervention periods, respectively (P < .0001). This effect was also observed in the medical and trauma ICUs, with decreased rates from 67.15 ± 10.56 to 17.4 ± 4.6 (P < .0001) and from 55.9 ± 8.95 to 14.71 ± 4.45 (P = .0004), respectively. CONCLUSION: Weekly and systematic dissemination of the findings of a bundle of interventions was successful in decreasing the rates of carbapenem-resistant A baumannii across a large public hospital.

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