Health Care Management Review最新文献

{"title":"A configurational approach to the relationship between ethnic diversity, leadership, and performance in health care teams.","authors":"Timur Uman, Norbert Steigenberger, Diana Nichitelea, Magnus Berndtzon, Manuela Schmidt","doi":"10.1097/HMR.0000000000000451","DOIUrl":"10.1097/HMR.0000000000000451","url":null,"abstract":"<p><strong>Background: </strong>Health care services are increasingly delivered by ethnically diverse teams. Understanding how these teams function and should be managed to improve clinical performance is critical to improving the quality and safety of care.</p><p><strong>Purpose: </strong>The aim of this study was to identify configurations of conditions that enable ethnically diverse health care teams to improve their clinical performance.</p><p><strong>Methodology/approach: </strong>This study uses video data from 59 simulations collected at a simulation center in southern Sweden in October 2022 and December 2023, supplemented by survey data. The simulations include 28 observations of CEPS (Concept for Patient Simulation) and 31 observations of PROBE (Practical Obstetric Team-Training). Fuzzy-set qualitative comparative analysis was used to explore combinations of conditions that lead to high performance.</p><p><strong>Results: </strong>A laissez-faire leadership style does not enable high performance in either ethnically homogeneous or heterogeneous teams. Ethnically diverse health care teams excel with shared leadership, especially when these teams are larger and less experienced. In addition, small and experienced teams perform well with shared leadership, regardless of ethnic diversity. Autocratic leadership is ineffective in ethnically diverse teams and effective only in small, ethnically homogeneous teams.</p><p><strong>Practice implications: </strong>The study highlights the importance of active leadership for optimal performance in health care teams, regardless of ethnic diversity. These findings provide valuable guidance for managers and practitioners responsible for staffing or leading diverse teams in hospitals.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"50 4","pages":"285-295"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158813","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":"Diabetes management in the context of social needs: A qualitative process evaluation from care team members' perspectives.","authors":"Daniel M Walker, Christine Swoboda, Nicolette Coovert, Jennifer A Garner, Katharine Garrity, Jennifer L Hefner, Ann Scheck McAlearney, Seuli Bose Brill, Joshua J Joseph","doi":"10.1097/HMR.0000000000000453","DOIUrl":"10.1097/HMR.0000000000000453","url":null,"abstract":"<p><strong>Background: </strong>Clinical management of Type 2 diabetes (T2D) can be hindered by patients' nonmedical, health-related social needs such as financial strain, housing instability, or food insecurity.</p><p><strong>Purpose: </strong>The objective of this study was to characterize the contextual factors and processes that influence care team members' abilities to address social needs impacting T2D management in outpatient settings.</p><p><strong>Methodology/approach: </strong>We conducted semistructured, qualitative interviews (N = 38) in tandem with the launch of a randomized controlled trial testing a patient-level intervention to improve diabetes outcomes in individuals experiencing food insecurity. We purposively selected a diverse array of care team members (e.g., physicians, social workers, diabetes educators, dietitians, community health workers) working across varying ambulatory clinics (e.g., family medicine, general internal medicine, endocrinology). All were affiliated with an academic medical center serving a diverse population in a Midwestern metropolitan area. Guided by a process evaluation framework, interview transcripts were coded and analyzed for themes via iterative deductive and inductive processes.</p><p><strong>Results: </strong>Contextual factors influencing T2D management for patients with social needs included telehealth policy, insurance coverage, and partnerships. Relevant implementation processes were categorized along a temporal continuum: previsit (i.e., transportation, social needs screening), during visit (i.e., appointment duration, care team member awareness, and communication of resources), and postvisit (i.e., closed-loop referrals). Mechanisms of impact included availability of support staff as well as availability of programs and resources to address social needs.</p><p><strong>Conclusions: </strong>Strengthening partnerships and considering logistics can help promote awareness of existing programs, facilitate bidirectional communication about use of services, and support overall clinical management of T2D for patients with social needs.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"50 4","pages":"305-314"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12893343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158800","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":"Development and preliminary validation of a survey assessing technology innovation readiness in health care settings.","authors":"Zhanna Novikov, Honor Shannon Magon, Xiao Li, Esther Ann Olsen, Roger Bohn, Sara J Singer","doi":"10.1097/HMR.0000000000000450","DOIUrl":"10.1097/HMR.0000000000000450","url":null,"abstract":"<p><strong>Background: </strong>Innovation readiness is crucial for transformative changes and enhanced performance in health care and depends on multiple factors including trust, training, and unit dynamics.</p><p><strong>Purposes: </strong>We develop and validate a survey measuring innovation readiness in health care organizations, focusing on dispositional, situational, and learned dimensions. We identify individual and unit factors that constitute innovation readiness.</p><p><strong>Methodology/approach: </strong>We administered a survey assessing individual (e.g., autonomy at work) and unit (e.g., unit innovation climate) characteristics to 593 intensive care unit (ICU) clinicians across four ICUs (50.3% response). We used principal component analysis with varimax rotation to assess psychometrics and t tests to examine groups' differences.</p><p><strong>Results: </strong>Psychometric analysis detected seven factors; five multi-item factors, namely, trust in technology, concerns about technology, unit innovation climate, unit manager commitment to technology, and professional identity assessing innovation readiness; four factors with Cronbach's alpha values ranging from 0.79 to 0.90; and two individual single-item factors measuring unit human-technology interdependence and unit training on technology. Individual and unit factors related to technology innovation readiness differed by professional discipline, unit, and tenure.</p><p><strong>Conclusion: </strong>The survey exhibited reliability in four ICUs in one hospital, suggesting that this 21-item tool can be used in similar settings. Variation in innovation readiness among professional disciplines and units highlights the importance of tailored approaches when introducing new technologies.</p><p><strong>Practice implications: </strong>Managers can use this survey to gauge readiness and address individual and unit needs before implementing new technologies. Future research should validate this tool in diverse health care contexts to expand the literature on technology innovation readiness.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"50 4","pages":"271-284"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158826","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":"Associations between physician-hospital integration and U.S. acute care hospital financial performance.","authors":"Xiao Li, Rebecca S Wells, Andrea Cervin, Vahed Maroufy, Ross Shegog","doi":"10.1097/HMR.0000000000000449","DOIUrl":"10.1097/HMR.0000000000000449","url":null,"abstract":"<p><strong>Background: </strong>Physician-hospital integration (PHI) is a popular strategy for enhancing the relationship between hospitals and physicians to thereby improve hospital performance, including financial viability.</p><p><strong>Purpose: </strong>Using a new objective-oriented PHI categorization, this study aimed to assess how both hospital-and system-level financial, clinical, and financial/clinical hybrid PHIs were associated with U.S. acute care hospitals' financial performance.</p><p><strong>Methodology/approach: </strong>We conducted a cross-sectional study using secondary data from six sources to assess the impact of hospital- and system-level PHI on hospital financial performance. We employed multiple linear regression to analyze the relationships between PHIs and hospital operating margin, total margin, and salaries to net patient revenue, separately.</p><p><strong>Results: </strong>Hospital-level financial PHIs were associated with higher salaries to net patient revenue (considered a negative financial outcome), whereas system-level financial PHIs were associated with higher operating margin, higher total margin, and lower salaries to net patient revenue (indicating higher revenue generation efficiency). System-level clinical PHIs were associated with higher salaries to net patient revenue. Financial/clinical hybrid PHI showed mixed outcomes.</p><p><strong>Conclusion: </strong>Our study suggests that system-level financial PHI and financial/clinical hybrid PHI may improve hospital financial performance, whereas system-level clinical PHIs have some negative financial effects.</p><p><strong>Practice implications: </strong>Our findings imply the value of examining the effects of PHI categorized in terms of the benefits of contractual structures to align financial goals with physicians. Although hospital executives may have limited control over system-level PHI, it may also be beneficial to anticipate the outcomes of system-level PHI for their facilities' performance.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"50 4","pages":"337-346"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158771","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":"Advancing organizational mindfulness in nursing: Bridging the theory-implementation gap.","authors":"Tmira Hefetz, Anat Drach-Zahavy","doi":"10.1097/HMR.0000000000000443","DOIUrl":"10.1097/HMR.0000000000000443","url":null,"abstract":"<p><strong>Background: </strong>According to organizational mindfulness (OM) theory, teams must constantly anticipate and recover from unforeseen events by avoiding oversimplified explanations, being attuned to operational details, maintaining commitment to resilience, engaging in preoccupation with failure, and prioritizing expertise in problem solving. Despite its merits, the assimilation of OM theory into health care systems remains challenging, as fundamental practices and procedures within these systems often conflict with the core principles of OM, leading to an implementation gap.</p><p><strong>Purpose: </strong>We begin by emphasizing why health care professionals, particularly nurses, are not yet ready for and even resistant to OM. Although OM is intensely patient focused and enables nurses to practice in alignment with the ideals of nursing, they may be reluctant to embrace it due to the burden it places on them without adequate resources.</p><p><strong>Methodology: </strong>We argue that readiness for change (RFC) theory offers valuable insights into addressing this challenge by identifying and mitigating barriers to change. We combine research on OM with the RFC model to conceptualize how to systematically integrate OM into health care settings.</p><p><strong>Findings: </strong>Conceptually integrating RFC and OM frameworks can aid in narrowing the OM theory-implementation gap. To advance the field further, OM scholars should focus on better operationalizing OM principles, designing interventions to implement OM, and assessing their effectiveness with longitudinal designs and identify contextual boundary conditions for OM effective implementation. Moreover, we describe how leaders can support OM and RFC while managing resource constraints and supporting overwhelmed health care workers.</p><p><strong>Practice implications: </strong>We distill our analysis into the 6-Step Road Map, suggesting evidence-based strategies for health care policymakers, administrators, and managers aiming to implement OM.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"250-260"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054418","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":"Delivering health care without degrading health: Factors associated with hospital commitment to environmental sustainability.","authors":"Rebecca Ranucci","doi":"10.1097/HMR.0000000000000439","DOIUrl":"10.1097/HMR.0000000000000439","url":null,"abstract":"<p><strong>Background: </strong>In delivering health care, hospitals contribute to climate change, which adversely impacts human health. Given this paradox, there are mounting efforts to encourage environmental sustainability in hospitals.</p><p><strong>Purpose: </strong>With growing attention on the environmental impact of hospitals and the adverse health effects of climate change, the purpose of this study is to examine factors that influence the likelihood of hospital commitment to environmental sustainability.</p><p><strong>Methodology: </strong>Using data on U.S. hospitals in 2022, the study estimates logit models to predict the likelihood of signing The White House Health Sector Climate Pledge.</p><p><strong>Results: </strong>Health system size is positively associated with the likelihood of hospital commitment to environmental sustainability and when interacting with nonprofit control this association strengthens. The delivery of uncompensated care increases the likelihood of commitment, but commitment declines at high levels of uncompensated care. Contrary to expectations, hospitals operating in communities that experience the most harmful health impacts from climate change are less likely to commit to sustainability.</p><p><strong>Conclusion: </strong>A hospital's priorities and structure facilitate attention toward environmental sustainability, but external factors that draw attention to the need for environmental sustainability do not stimulate, and instead stifle, sustainability commitment.</p><p><strong>Practice implications: </strong>Hospital leaders, advocacy groups, and policymakers should not assume the experience of adverse climate-related health outcomes leads hospitals to make commitments to environmental sustainability, but rather focus should be on actively building coalitions, starting with nonprofit, larger system-affiliated hospitals, already predisposed to prosocial behavior, in order to rally broader commitment toward environmental sustainability in the health care sector.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"175-184"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701767","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":"Predictors and effects of hospital chief executive officer turnover: A systematic review.","authors":"Marius Hermes, Vera Winter, Eva-Maria Wild","doi":"10.1097/HMR.0000000000000441","DOIUrl":"10.1097/HMR.0000000000000441","url":null,"abstract":"<p><strong>Background: </strong>Chief executive officer (CEO) turnover is especially frequent in hospitals and represents a critical organizational event, yet its predictors and effects remain poorly understood.</p><p><strong>Purpose: </strong>We conducted a systematic review of the empirical literature on the predictors and effects of hospital CEO turnover worldwide to synthesize and assess the multiple findings scattered across studies.</p><p><strong>Methodology: </strong>In this systematic review, 30 empirical studies published between 1987 and 2024 were identified from three databases: Business Source Complete, MEDLINE, and APA PsycInfo. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.</p><p><strong>Results: </strong>We found that the methodological quality of the studies was highly variable. Furthermore, we identified 46 unique predictors of hospital CEO turnover, including organizational, environmental, and personal characteristics, as well as characteristics related to prior performance. The findings regarding the effects of CEO turnover suggest that it can result in a temporary decline in financial performance and an elevated risk of organizational failure for hospitals.</p><p><strong>Practice implications: </strong>Our results underscore that, in hospitals with a higher likelihood of CEO turnover, early and systematic succession planning is crucial to increase leadership stability, reduce recruitment costs, and ensure organizational resilience.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"197-210"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062820","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":"Exploring the relationship between organizational equity orientation and community orientation: A comprehensive analysis of the U.S. hospital landscape.","authors":"Reena Joseph Kelly, Neeraj Puro, Gregory N Orewa, Phil Cendoma","doi":"10.1097/HMR.0000000000000438","DOIUrl":"10.1097/HMR.0000000000000438","url":null,"abstract":"<p><strong>Background: </strong>Community orientation, developed and fostered through partnerships between hospitals and community organizations, is a key approach for health care organizations to build deeper community ties. Such efforts are instrumental in building trust within the community, and one way for hospitals to do so is to develop a strong organizational equity orientation as a strategic priority.</p><p><strong>Purpose: </strong>The aim of the study was to explore the association between hospitals' organizational equity and community orientation using Moulton's publicness theory framework, which focuses on cultural-cognitive, regulative, and normative public value.</p><p><strong>Methodology/approach: </strong>Using data from 2021 to 2022 American Hospital Association annual surveys and the 2018 Social Capital Project, a Poisson model with random effects was conducted to assess the association between hospitals' internal equity orientation and community orientation.</p><p><strong>Results: </strong>Hospitals with higher organizational equity orientation were associated with an increased degree of community orientation (incident rate ratio [IRR] = 1.04, p < .001). Not-for-profit and public hospital ownership (IRR = 1.66 and 1.53, p < .001, respectively), teaching status ( IRR = 1.08, p < .001), The Joint Commission accreditation ( IRR = 1.07, p < .001), and higher social capital (IRR = 1.10, p < .05) were also associated with higher degree of community orientation.</p><p><strong>Conclusions: </strong>As hospitals explore opportunities to reduce disparities and improve equity, they should focus on measuring and assessing organizational equity orientation at various levels, which can, in turn, offer an advantage in deepening community relationships.</p><p><strong>Practice implications: </strong>With increasing emphasis from Centers for Medicare & Medicaid Services on health equity and community partnerships, hospitals prioritizing organizational equity in multiple ways may stand to benefit. By demonstrating a commitment to equity within the organizations, hospitals will be more likely to gain trust from community partners.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"165-174"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711605","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":"Mitigating patients' negative responses to health care asset sharing through explanatory information provision.","authors":"Caroline Rothert-Schnell, Sebastian Böddeker, Gianfranco Walsh","doi":"10.1097/HMR.0000000000000445","DOIUrl":"10.1097/HMR.0000000000000445","url":null,"abstract":"<p><strong>Background: </strong>Sharing health care assets promises to enhance asset utilization, increase efficiency, and reduce costs, but this tactic also might risk adverse patient outcomes. Identifying potential mitigation strategies thus represents a pressing research need.</p><p><strong>Purposes: </strong>This study investigates the effects of sharing a health care asset on patients' perceptions, as well as how providing explanatory information might mitigate the negative effects of such sharing on patient outcomes.</p><p><strong>Methodology/approach: </strong>Building on signaling theory and data gathered from a scenario-based experiment (n = 303 German participants), the authors perform regression analyses, in which trust in the physician and perceived risk represent mediators of the relationship between sharing a health care asset and patients' intentions to return. They also explore if physicians' explanatory information provision functions as a moderator.</p><p><strong>Findings: </strong>Trust in the physician and perceived risk serially mediate the effect of sharing a health care asset on patients' intentions to return. Explanatory information provision can mitigate the negative effects of asset sharing on patients' trust in the physician.</p><p><strong>Practice implications: </strong>Explanatory information provision is crucial for implementing shared asset use strategies in the health care sector, because it offers the potential to mitigate the negative effects of such uses on patient outcomes. Health care providers pursuing shared asset strategies should provide patients with clear information about the shared asset, to prevent adverse effects.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"232-240"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024726","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":"Exploring perspectives on the management of patients with complex care needs in stroke rehabilitation: An interpretive description study.","authors":"Alyssa Indar, Michelle Nelson, Whitney Berta, Maria Mylopoulos","doi":"10.1097/HMR.0000000000000440","DOIUrl":"10.1097/HMR.0000000000000440","url":null,"abstract":"<p><strong>Background: </strong>Exploring the \"wicked\" problem of improving care for patients with complex care needs could benefit a large swath of health system stakeholders given the breadth and depth of this issue. Patients with complex health and social needs often require customized care that deviates from expected care trajectories. At Canadian Stroke Distinction sites, clinicians provide care for a high proportion of patients with complex needs while adhering to best practice recommendations.</p><p><strong>Methods: </strong>We conducted an interpretive description study, which explored the perspectives of 16 stroke rehabilitation clinicians, four organizational key informants, and two health system key informants. We collected data via 45- to 60-minute virtual interviews and engaged in a hybrid inductive-deductive approach to analysis.</p><p><strong>Results: </strong>We constructed three main themes: (a) recognizing complexity is routine work for clinicians, (b) clinicians use workarounds to manage complexity, and (c) clinicians perceived and worked to bridge a difference between organizational processes and the realities of patient care. When comparing clinician and key informant perspectives, we noted differences regarding their perceptions of the prevalence and nature of patient complexity. We developed the concept of \"work-as-expected\" as an intermediary to bridge the gap between the \"work-as-imagined\" and \"work-as-done\" framework.</p><p><strong>Conclusion: </strong>We describe the strategies used by expert clinicians to continually manage care for a high proportion of patients with complex care needs. Although expert clinicians have developed effective workarounds, they experience significant moral distress when these strategies are unable to compensate for health system limitations.</p><p><strong>Practice implications: </strong>A better understanding of how clinicians manage the needs of patients with complex care needs could support policymakers and organizational leaders to consider macro- and meso-level strategies to support the adaptive practices of clinicians.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"185-196"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054421","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}