Health Care Management Review最新文献

{"title":"From scut work to strategy: Why and how resident doctors can use cognitive crafting to stay in training.","authors":"Wen Wang, Hannah Weisman, Helen Steed","doi":"10.1097/HMR.0000000000000515","DOIUrl":"https://doi.org/10.1097/HMR.0000000000000515","url":null,"abstract":"<p><strong>Background: </strong>Across the globe, resident doctors, physicians in postgraduate training to become specialists, report high dissatisfaction, with many considering leaving training. A key driver is the growing burden of scut work- \"mundane tasks\" including repetitive administrative and routine clinical work, driven by legislation, staffing shortages, and workplace inefficiencies.</p><p><strong>Purpose: </strong>This study examines why and how cognitive crafting, thinking about mundane tasks as valuable for one's development as a doctor, may support retention in medical training.</p><p><strong>Methodology: </strong>Using survey data from 270 resident doctors in the United Kingdom, we tested hypotheses proposing that perceived job-role alignment and career progression self-efficacy mediate the negative relationship between understanding the value of mundane tasks and intentions to leave training. A supplemental analysis of 35 qualitative interviews further illuminated the mechanisms underlying these results.</p><p><strong>Results: </strong>The significant negative association between understanding the value of mundane tasks and intentions to leave training was fully mediated by perceived job-role alignment, as well as by a sequential pathway operating through perceived job-role alignment and then career progression self-efficacy. Qualitative findings suggest that doctors can view mundane tasks as valuable opportunities for relationship-building, socialization, and learning.</p><p><strong>Conclusion: </strong>Our findings indicate that cognitive crafting may support resident doctors' retention by enhancing perceived job-role alignment and career progression self-efficacy.</p><p><strong>Practice implications: </strong>Training programs could explicitly frame routine tasks as integral to professional development and support resident doctors in cognitively reframing them as meaningful work.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of experienced compassion at work on nursing home certified nursing assistants' well-being and turnover intentions.","authors":"Kristin M MacDonald, Jessica N Mittler, Laura E McClelland, Christopher S Reina, Adam Atherly","doi":"10.1097/HMR.0000000000000511","DOIUrl":"https://doi.org/10.1097/HMR.0000000000000511","url":null,"abstract":"<p><strong>Background: </strong>Certified nursing assistants (CNAs) are essential to health care delivery in U.S. nursing homes (NHs), yet these direct caregivers are affected by high turnover, which impacts care quality. CNA turnover is costly, resulting in 6-figure annual losses for many NHs. Improving well-being and retaining employees is important for NH survival. Compassion benefits employees and their organizations, and may offer NHs a promising solution.</p><p><strong>Purpose: </strong>We study whether experienced compassion at work (experienced compassion) predicts higher well-being (meaningfulness of work [MOW], psychological vitality [vitality], and resilience) for NH CNAs, and if well-being predicts lower job and profession-level turnover intentions.</p><p><strong>Methodology/approach: </strong>In-person survey data were collected from CNAs (n=71) at three timepoints in a convenience sample of Kansas and Virginia NHs. Hypothesized models were tested using path analyses after validating scale reliability.</p><p><strong>Findings: </strong>Experienced compassion predicts higher MOW, vitality, and resilience. Vitality predicts lower job turnover intentions; vitality and MOW predict lower CNA profession turnover intentions. Experienced compassion predicts lower CNA profession turnover intentions via MOW with a total effect of b=-0.83. In all models, experienced compassion predicts lower turnover intentions (b=-0.45 to -0.81).</p><p><strong>Conclusions: </strong>Experienced compassion benefits CNAs and their NHs, and may promote LTC workforce sustainability.</p><p><strong>Practical implications: </strong>Managers should seek ways to support experienced compassion between caregivers and care recipients (e.g., recognize and reward compassionate caregivers) and among co-workers (e.g., peer mentoring programs).</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinician satisfaction with hospital at home: A multilevel framework.","authors":"Wiljeana Glover, Olubunmi Ajayi, Dessislava Pachamanova, Susan Stempek, Andres Solorza, Susan Moffatt-Bruce","doi":"10.1097/HMR.0000000000000512","DOIUrl":"https://doi.org/10.1097/HMR.0000000000000512","url":null,"abstract":"<p><strong>Background: </strong>Hospital at Home (HaH) programs provide acute inpatient-level care, can expand the capacity of traditional hospitals, and help address ongoing inpatient bed capacity issues while maintaining quality of care. While prior studies have explored patient satisfaction with HaH, scholars highlight a need for research into clinician satisfaction with HaH.</p><p><strong>Purpose: </strong>This study identifies factors that influence clinician satisfaction with the HaH model and suggests an approach for effective program design and implementation.</p><p><strong>Approach: </strong>This study takes a qualitative approach, examining the perspectives of twenty clinicians, including hospitalists, advanced practice providers (defined as nurse practitioners and physician assistants), and registered nurses who treated patients in the HaH program of a mid-sized hospital between August 2023 and June 2025.</p><p><strong>Results: </strong>We developed a multilevel framework, identifying satisfaction factors at the micro (individual), meso (team, patients, and families), and macro (hospital processes and technology) levels.</p><p><strong>Conclusion: </strong>Our findings suggest that HaH may be a pathway to address clinicians' satisfaction (e.g., need for achievement) and shield from dissatisfaction factors (e.g., variety as a pathway for preventing burnout). We also identify opportunities for further development for the HaH model that may improve satisfaction.</p><p><strong>Practice implications: </strong>Health care leaders should consider implementing HaH models, provided they remain supported by legislation, as they may offer a positive team-based care experience for clinicians and patients alike while delivering high-quality acute care and leveraging technology to extend capacity for health systems.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transformative promise and implementation challenges: Health care managers' perceptions and experiences of artificial intelligence-A mixed-methods systematic review.","authors":"Merja Hirsikorpi, Mira Hammarén, Erika Jarva, Outi Kanste","doi":"10.1097/HMR.0000000000000510","DOIUrl":"https://doi.org/10.1097/HMR.0000000000000510","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) is a technological development that offers new opportunities for managing health care services.</p><p><strong>Purpose: </strong>To identify and synthesize the best evidence on health care managers' and other professionals´ experiences and perceptions of the utilization of AI in management.</p><p><strong>Methodology/approach: </strong>A mixed-methods systematic review was conducted following the Joanna Briggs Institute methodology using a convergent integrated approach, including qualitative and quantitative data synthesis followed by thematic analysis. A systematic search was conducted in January 2025 in Ovid Medline, CINAHL, Scopus, ProQuest and Medic, limiting studies between 2016 and 2025 and written in English, Swedish, or Finnish.</p><p><strong>Findings: </strong>The results were reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). A total of 16 studies from 10 countries were included, comprising 11 qualitative and 5 quantitative studies. Of the participants, 90% were health care managers, and 10% were other health care professionals, such as nurses, physicians, and developers. The thematic analysis identified five themes reflecting participants' perceptions and experiences: AI as a transformative mechanism, organizational enablers and outcomes of AI utilization, AI-supported operational and risk management efficiency, strategic financial benefits and long-term value creation through AI, and data-driven opportunities and challenges in AI utilization for health care management.</p><p><strong>Practice implications: </strong>Health care managers should strengthen AI-related competencies, data governance, and organizational readiness to support effective AI implementation. Leadership practices that foster innovation, workforce engagement, and responsible data-driven decision-making may help organizations realize the operational and strategic benefits of AI.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do no harm? How health care management research can advance environmentally sustainable health care.","authors":"Maike V Tietschert, Jülide N Çelik, Alexander Negron Price, Sara J Singer, Andrew N Garman, Erik M Van Raaij","doi":"10.1097/HMR.0000000000000503","DOIUrl":"10.1097/HMR.0000000000000503","url":null,"abstract":"<p><strong>Issue: </strong>Health care organizations face pressure to advance environmental sustainability. Core challenges include pursuing distant-future goals (e.g., climate neutrality by 2050), leading sustainability initiatives beyond formal authority, and making mitigation decisions whose benefits accrue in the future and outside the organization.</p><p><strong>Critical theoretical analysis: </strong>Dominant management theories tend to treat the future as a strategic context or planning horizon rather than as an object of sustained organizational work. Long-term orientation is often assumed rather than explained. Leadership is conceptualized as hierarchical or professionally anchored, leaving distributed and extra-professional leadership weakly theorized. Moreover, prevailing theories assume alignment between decision-makers and beneficiaries, privileging value creation and capture while inadequately addressing harm reduction and externalized and future-oriented environmental benefits and costs.</p><p><strong>Insight/advance: </strong>We suggest a shift from treating the future as a given condition to be anticipated or adapted to, toward actively pursuing distant futures as ongoing organizational work. We conceptualize sustainability leadership as distributed across fragmented authority structures and reframe environmental sustainability as a governance challenge of managing asymmetric costs and benefits alongside clinical priorities. Reframing of sustainability leadership provides opportunities for healthcare management research to advance environmentally sustainable health care through managerial work.</p><p><strong>Practice implications: </strong>We highlight the need for health care managers to actively sustain future-oriented goals over time, lead sustainability initiatives without relying solely on formal authority, and develop decision and performance frameworks capable of integrating temporally and spatially uneven payoffs.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"273-283"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13492644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing through transformation: Organizational responses to financial precarity and the Rural Health Transformation Program.","authors":"Larry R Hearld, Cheryl Rathert","doi":"10.1097/HMR.0000000000000507","DOIUrl":"10.1097/HMR.0000000000000507","url":null,"abstract":"","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"51 4","pages":"271-272"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why physicians resist artificial intelligence: A systematic review through the lens of diffusion of innovations.","authors":"Michele L Heath, Kristin Burton, Navneet C Grant, Tracy H Porter","doi":"10.1097/HMR.0000000000000500","DOIUrl":"10.1097/HMR.0000000000000500","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) enabled systems hold significant promise for transforming health care delivery. These technologies are frequently developed and commercialized by firms focused on creating innovative products or services and positioning them as essential solutions for clinical and organizational needs. However, despite their transformative potential, the integration of artificial intelligence into routine clinical practice has been met with notable resistance from physicians.</p><p><strong>Purpose: </strong>The purpose of this systematic review was to examine the factors contributing to physicians' resistance to AI-enabled technologies in clinical practice. Rogers' Diffusion of Innovations (DOI) theory was employed as the guiding theoretical framework to analyze how perceived innovation attributes shape physician resistance.</p><p><strong>Methodology/approach: </strong>We conducted a PRISMA-guided systematic literature review across five databases, examining sixteen empirical studies from the United States published in English.</p><p><strong>Conclusion: </strong>We identified resistance factors for AI among physicians in clinical practice using a deductive approach guided by Rogers' Diffusion of Innovations (DOI) framework, focusing on perceived relative advantage, compatibility, and complexity of AI-enabled technologies.</p><p><strong>Practice implications: </strong>These findings show that physician adoption of AI tools depends on whether innovations demonstrably improve clinical quality, efficiency, and workload compared with existing practices. Adoption is strengthened when hospital leaders make benefits visible through data, pilots, physician champions, and collaborative testing environments that build trust and reduce uncertainty about the technology's value.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"316-325"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"M&A reality check: A longitudinal study of operational cost performance in U.S. hospitals.","authors":"Yousef Abdulsalam, Mikaella Polyviou, Eugene Schneller","doi":"10.1097/HMR.0000000000000502","DOIUrl":"10.1097/HMR.0000000000000502","url":null,"abstract":"<p><strong>Background: </strong>Hospital mergers and acquisitions (M&As) reduce resource dependence on sources of input and purchasers of output, via market power, service diversification, and operational efficiency. While prior research has examined M&A effects on quality and pricing, less is known about their effects on supply chain cost performance-a core input to health care delivery and a frequently cited but not always realized driver of consolidation.</p><p><strong>Purpose: </strong>To determine the impact of hospital M&As on acquired hospital operating costs, in terms of magnitude and timing, and compare possible efficiencies in supply expenses relative to other expense categories.</p><p><strong>Methodology: </strong>We analyzed a longitudinal data set of U.S. acute care hospitals (2016-2021) using propensity score matching and panel regression. This approach isolated the effect of merger events on total operating expenses, salary expenses, supply expense categories (medical-surgical and pharmaceutical), and net income.</p><p><strong>Findings: </strong>Acquired hospitals experienced significant reductions in total operating expenses in the postmerger period. These savings were largely attributable to streamlined payroll costs. We observed a modest reduction in medical-surgical supply costs 1 year post-acquisition, but no significant change in pharmaceutical supply costs.</p><p><strong>Practice implications: </strong>Supply chain cost savings from hospital acquisitions are easy to imagine but elusive to realize. Hospital leaders should first seek targets whose supply chain operations, strategies, and partners fit their own, and proactively communicate and integrate supply chain operations during post-acquisition planning to realize the anticipated operational synergies.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"336-345"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13492645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burned out and ready to leave? How workplace violence drives turnover among Chinese nurses and the role of well-being HRM.","authors":"Timothy Bartram, Patricia Pariona-Cabrera, Qinyan Gong, Xiaoyan Liang, Di Fan, Jessica Borg, Hannah Meacham, Tse Leng Tam, Shea Fan, Jillian Cavanagh, Justine Ferrer, Peter Holland","doi":"10.1097/HMR.0000000000000499","DOIUrl":"10.1097/HMR.0000000000000499","url":null,"abstract":"<p><strong>Background: </strong>Workplace violence is a growing phenomenon in health care settings, which negatively impacts nurses' physical and mental well-being and intention to leave. Understanding the forces that shape nurses' intention to leave is therefore fundamental to safeguarding the quality of patient care, patient safety, and system sustainability, a critical and central concern for health care management.</p><p><strong>Purpose: </strong>Against a backdrop of workplace violence, high workloads, and chronic nurse burnout, we test the mediating role of burnout on the relationship between workplace violence and intention to leave. We also test the buffering role of well-being human resource management (WBHRM) on the relationship between burnout and intention to leave, so that higher levels of WBHRM will mitigate the positive relationship between burnout and intention to leave.</p><p><strong>Methodology/approach: </strong>We test these hypotheses using the conservation of resources (COR) theory and a three-wave matched sample of 179 nurses working in a large Chinese health service.</p><p><strong>Findings: </strong>We confirm one of our two hypotheses. We report that nurse burnout positively mediates the relationship between workplace violence and intention to leave. However, interestingly, we find that WBHRM does not buffer the relationship between nurse burnout and intention to leave but actually exacerbates this relationship.</p><p><strong>Practical implications: </strong>We discuss the health care management implications of our findings and suggest various possible explanations for WBHRM exacerbating the relationship between burnout and intention to leave. We suggest that health care managers need to understand WBHRM within its wider social context, the proactive use of HRM practices to prevent violence and burnout before significant personal resource loss, and the need for structural changes in hospital settings to tackle systemic workforce challenges such as high workloads and work intensification.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"51 4","pages":"307-315"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of organizational inclusion for a diverse workforce on organizational climate assessments and hospital recommendations among nurse practitioners.","authors":"Hyunmin Yu, Kathryn A Connell, Daniela Golinelli, Matthew D McHugh, Tari Hanneman, Jose A Bauermeister, Heather Brom","doi":"10.1097/HMR.0000000000000505","DOIUrl":"10.1097/HMR.0000000000000505","url":null,"abstract":"<p><strong>Background: </strong>While the nursing profession has advocated for workforce diversity, limited research has examined how institutional inclusion efforts are associated with the experiences of nurse practitioners (NPs), particularly in hospital settings.</p><p><strong>Purpose: </strong>To examine whether institutional inclusion efforts were associated with NPs' strong recommendation of their hospital and whether this relationship was explained by NPs' assessments of organizational climate.</p><p><strong>Methods: </strong>This cross-sectional study analyzed 2023 data from 742 NPs across 412 U.S. hospitals, drawing on the Penn Nurses4All Survey, the Healthcare Equality Index (HEI), and the American Hospital Association Annual Survey. The independent variable was employment in an HEI-participating hospital, and the dependent variable was NPs' strong recommendation of their hospital to family and friends. Mediating variables included NPs' assessments of organizational climate. Mediation analysis using weighting estimators was conducted to adjust for confounding and evaluate the extent to which organizational climate explained the relationship between HEI participation status and hospital recommendation.</p><p><strong>Results: </strong>NPs in HEI-participating hospitals were 15% more likely to strongly recommend their hospital (95% CI: .07-.22). Significant indirect associations were observed and accounted for the total association through overall organizational climate (26.6%), professional visibility (26.6%), and NP-administration relations (20%), respectively.</p><p><strong>Practice implications: </strong>Hospital participation in the HEI is associated with stronger hospital recommendations among NPs, partly through more favorable assessments of organizational climate. As health care systems work to improve work environments and job outcomes for a diverse workforce, cultivating a climate of inclusion through meaningful, everyday practices will be essential.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"51 4","pages":"357-365"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}