Frontiers in health services最新文献

{"title":"Impact of birth defect prevention and control programs on mortality among children with birth defects from 2012 to 2023 in Shenzhen, China.","authors":"Xueyu Yang, Guanglin Zhao, Jing Zheng, Shuyan Jin","doi":"10.3389/frhs.2025.1657703","DOIUrl":"10.3389/frhs.2025.1657703","url":null,"abstract":"<p><strong>Background: </strong>Birth defects are an important cause of fetal and neonatal mortality and represent a major global public health concern. Shenzhen has implemented several prevention and control programs in recent years. However, the effectiveness in reducing mortality among affected children has not been systematically evaluated.</p><p><strong>Objective: </strong>To assess the impact of birth defect prevention and control programs on mortality among children with birth defects in Shenzhen from 2012 to 2023, and to provide evidence for program evaluation and maternal-child health policy development.</p><p><strong>Methods: </strong>All registered cases of children with birth defects in Shenzhen between 2012 and 2023 were included. The study period was divided into three phases according to program implementation: Phase I (2012-2017), Phase II (2018-2021), and Phase III (2022-2023). Mortality outcomes included early fetal death, late fetal death, and early neonatal death. Trends were analyzed using the Cochran-Armitage test with Bonferroni-adjusted pairwise comparisons. Multivariable logistic regression adjusted for confounders and subgroup analyses were conducted by maternal household registration status (local vs. non-local).</p><p><strong>Results: </strong>From Phase I to Phase III, early fetal mortality increased (26.1% vs. 29.7% vs. 33.4%), whereas late fetal mortality (5.7% vs. 4.1% vs. 3.6%) and early neonatal mortality (1.0% vs. 0.5% vs. 0.3%) declined significantly(<i>P</i> < 0.001 for trends). Logistic regression showed lower risks of late fetal and early neonatal death in Phases II and III compared with Phase I, with greater reductions among children of non-local mothers.</p><p><strong>Conclusion: </strong>Birth defect prevention and control programs in Shenzhen were associated with reduced late fetal and early neonatal mortality, especially in non-local populations, Providing evidence to guide maternal-child health policy.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1657703"},"PeriodicalIF":2.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study on the relationship between medical staff's knowledge, attitudes, and practices regarding medical waste classification and personality traits.","authors":"Jinyan Wang, Meifeng Liu, Deyu Wang","doi":"10.3389/frhs.2025.1609584","DOIUrl":"10.3389/frhs.2025.1609584","url":null,"abstract":"<p><strong>Aim and objectives: </strong>This study aims to assess healthcare workers' medical waste management knowledge, attitudes, and practices (KAP) and the influencing Factors; The study objectives are to explore the association between medical staff's personality traits and their KAP toward medical waste classification.</p><p><strong>Methods: </strong>A self-designed questionnaire assessing medical staff's knowledge, attitudes, and Practices toward medical waste classification, along with the Ten-Item Personality Inventory - Chinese version (TIPI-C), was administered to 420 nurses and doctors at a hospital in China. Group comparisons were performed using t-tests and ANOVA. Correlations between medical staff's knowledge and attitudes toward medical waste classification and TIPI-C were analyzed using Spearman's correlation. Influencing factors were examined through multiple stepwise regression analysis.</p><p><strong>Results: </strong>This study assessed the knowledge, attitudes, and practices (KAP) of medical waste classification among 420 healthcare professionals (214 nurses, 206 doctors) in a large Chinese hospital. The overall scores were 8.70 ± 1.63 for knowledge, 18.54 ± 3.11 for attitudes, and 24.20 ± 4.94 for practices. Nurses demonstrated significantly higher KAP levels than doctors across all domains (<i>P</i> < 0.05). Female staff outperformed males in knowledge (<i>β</i> = -0.162, <i>p</i> = 0.002), attitudes (<i>β</i> = -0.266, <i>P</i> < 0.001), and practices (<i>β</i> = -0.212, <i>P</i> = 0.002). Longer working experience was positively associated with knowledge (<i>β</i> = 0.113, <i>P</i> = 0.019). Higher education was also a positive predictor of knowledge (<i>β</i> = 0.132, <i>P</i> = 0.007). Among personality traits, openness showed a significant positive correlation with attitudes (<i>r</i> = 0.187, <i>P</i> < 0.01) and was a predictor of both attitudes (<i>β</i> = 0.160, <i>P</i> = 0.017) and practices (<i>β</i> = 0.154, <i>P</i> = 0.025) in regression analysis.</p><p><strong>Conclusions: </strong>This study revealed moderate to high levels of knowledge, attitudes, and practices (KAP) regarding medical waste classification among healthcare professionals, with nurses and female staff demonstrating significantly higher KAP scores. Key influencing factors identified include occupation, gender, years of experience, education level, and the personality trait of openness. These findings highlight the need for targeted, role-specific training programs to enhance compliance and safety in medical waste management. In addition to training, policy implications should include the integration of medical waste management into regular performance assessments and accountability mechanisms. Furthermore, fostering a culture of openness and continuous improvement through institutional support and feedback systems is recommended to sustain positive behavioral change.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1609584"},"PeriodicalIF":2.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health care benefits package design to improve outcomes in resource-constrained settings: suggestions for Tajikistan.","authors":"Jens Wilkens, Alona Goroshko, Malika Khakimova, Farrukh Egamov, Triin Habicht, Ilker Dastan","doi":"10.3389/frhs.2025.1617679","DOIUrl":"10.3389/frhs.2025.1617679","url":null,"abstract":"<p><p>The Tajik health system is characterized by improving health outcomes over the last 20 years, but also major inefficiencies in health care delivery and large difficulties for people to access affordable essential health care. The benefits package (BP) is a key tool for prioritizing state budget allocations toward health interventions that most effectively enhance health system performance. This article suggests directions for a new BP, which is envisioned in the currently ongoing reforms. Using a universal health coverage framework, the article examines how the public budget is prioritized in the current BP and investigates the main performance challenges addressed in the government's ongoing health reform efforts from a BP perspective. Criteria for a new BP are outlined, along with suggestions for their application. The article explains how BP design can improve health system performance in a budget-constrained setting by focusing on primary health care interventions and eliminating user fees for child and maternal health services, without requiring additional budget resources. The main strength of the current BP is the provision of free family doctor and nurse consultations for all. However, its narrow scope and high user fees for essential interventions hinder both the effective management of highly prevalent chronic non-communicable diseases and the efficient use of public resources. The user fee exemptions for vulnerable population groups are neither rational in design nor possible to evaluate due to the absence of data.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1617679"},"PeriodicalIF":2.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and effectiveness of a smartphone access program for promoting engagement in care among perinatal people with substance use disorders: a pilot study.","authors":"D J Goodman, L Lamadriz, K Stokes, M Adams, H Martell, K Robie, A Morgan, E C Saunders","doi":"10.3389/frhs.2025.1640311","DOIUrl":"10.3389/frhs.2025.1640311","url":null,"abstract":"<p><strong>Introduction: </strong>Pregnant and postpartum people with substance use disorders (SUD) experience high rates of morbidity and mortality, especially postpartum. For this vulnerable group, lack of access to a phone contributes to poor engagement in perinatal care. This paper describes initial work evaluating the implementation of a free smartphone program for rural pregnant patients with SUD and its effectiveness for improving participation in care.</p><p><strong>Methods: </strong>This retrospective type I hybrid-effectiveness cohort study evaluated program effectiveness, acceptability, and feasibility of implementation in obstetric practice. Semi-structured interviews with patients, providers and obstetric staff (<i>n</i> = 8) explored implementation success. Data on phone utilization, engagement in care and outcomes were abstracted from electronic health records and compared among three cohorts (Cohort 1: patients with SUD who received phones; Cohort 2: patients with SUD not receiving phones; Cohort 3: Patients without SUD). Kruskal-Wallis and chi-squared/Fisher's Exact tests were utilized for comparisons.</p><p><strong>Results: </strong>Providers, staff, and patients universally found the smartphone access program useful, perceiving that it improved patient engagement in digital and in-clinic care. From 2021 to 2024, 44 patients with SUD participated in the smartphone program for an average of 162 days. Cohort 1 entered prenatal care later, attended fewer prenatal visits, and were more likely to have psychiatric comorbidity than Cohorts 2 and 3. After receiving a smartphone, there were no differences in postpartum visits between cohorts, and higher rates of behavioral health and recovery support for Cohort 1.</p><p><strong>Discussion: </strong>In a rural obstetric clinic, implementing a free smartphone program for perinatal patients with SUD was feasible and acceptable. Though there was no difference in prenatal care utilization, patients who received a smartphone engaged in robust postpartum care and behavioral healthcare utilization. Addressing digital disparities is an essential component of health equity.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1640311"},"PeriodicalIF":2.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The uphill journey of smoking cessation in chronic obstructive pulmonary disease: why a well-built vehicle matters.","authors":"Rasmus Kragh Jakobsen, Ingeborg Farver-Vestergaard, Anders Løkke","doi":"10.3389/frhs.2025.1659295","DOIUrl":"10.3389/frhs.2025.1659295","url":null,"abstract":"<p><strong>Introduction: </strong>Smoking cessation remains among the most effective interventions for improving outcomes in patients with chronic obstructive pulmonary disease (COPD). Quitting smoking slows disease progression, reduces morbidity, improves quality of life and increases life expectancy. However, a substantial proportion of patients with COPD continue to smoke, and generic cessation strategies often fall short in this population. While most cessation research targets \"healthy\" smokers, individuals with COPD face additional challenges - including higher nicotine dependence and psychological comorbidities - that complicate quit attempts.</p><p><strong>Methods: </strong>This mini-review summarises randomised controlled trials (RCTs) investigating smoking cessation interventions in COPD.</p><p><strong>Results: </strong>Our study reveals wide variability in the intensity, duration and components of interventions, with only a minority achieving long-term abstinence. Notably, two high-performing studies stand out for their comprehensive, long-term and individualised approaches. These findings suggest that success in smoking cessation for patients with COPD relies not only on the right intervention components but also on the construction, durability and sustained support.</p><p><strong>Conclusion: </strong>To support and sustain smoking cessation among patients with COPD, multicomponent, high-intensity and long-duration interventions tailored to individual needs appear to be required, with an emphasis on ongoing support and frequent follow-up.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1659295"},"PeriodicalIF":2.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation climate and clinic personnel attitudes in primary care towards a mental health and drug use preventive intervention for hispanic families: preliminary findings.","authors":"Alyssa Lozano, Elliott R Weinstein, Tae Kyoung Lee, Justin D Smith, C Hendricks Brown, Guillermo Prado","doi":"10.3389/frhs.2025.1619869","DOIUrl":"10.3389/frhs.2025.1619869","url":null,"abstract":"<p><p>Despite the availability of preventive interventions to address mental health and drug use among Hispanic adolescents, few are implemented in real-world settings. Favorable attitudes towards evidence-based practices and a better implementation climate can facilitate the successful execution of interventions in real-word settings to ameliorate health disparities among Hispanic youth. The purpose of this study was to investigate how implementation climate influences attitudes toward a mental health and drug use preventive intervention for Hispanic families at the individual and clinic level. Participants included 73 clinic personnel from 18 primary care clinics that were part of an effectiveness-implementation hybrid Type 1 study in South Florida. Clinic personnel completed the Implementation Climate Scale and Evidence-based Practice Attitude Scale. Using hierarchal linear modeling, we examined: (1) whether individual differences in implementation climate were associated with individual attitudes towards an evidence-based practice within clinics, and (2) whether clinic-level differences in mean implementation climate were associated with clinic-level differences in attitudes towards an evidence-based practice. At the individual level, there was a significant positive relationship between individual implementation climate and attitudes toward the evidence-based practice. Implementation climate varied significantly among individuals. At the clinic level, clinics with higher average implementation climate did not show significantly different average attitudes towards the mental health and drug use preventive intervention. Understanding implementation climate and attitudes toward evidence-based practices can inform tailored implementation strategies for the unique needs of primary care settings to address drug use and mental health disparities among Hispanic youth.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1619869"},"PeriodicalIF":2.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and opportunities for greater public-private partnership for the implementation of the WHO operational framework for building climate resilient health systems to improve malaria control and elimination in Sub-Saharan Africa: a rapid review.","authors":"Sheila Lumumba, Samuel Kamau, Isaac Ntwiga, Josphat Martin Muchangi, Jackline Kiarie, Sarah Kosgei, Moses Mwamburi, George Kimathi","doi":"10.3389/frhs.2025.1593923","DOIUrl":"10.3389/frhs.2025.1593923","url":null,"abstract":"<p><p>The relationship between climate change and malaria is complex, with both predictable and unpredictable aspects. The impacts of climate change may promote mosquito breeding, increase parasite development rates and extend the geographical range of malaria vectors through increased temperature and rainfall. In addition, climate change influences the transmission of malaria indirectly through social and economic pathways. The gains made in malaria control are evidently under threat. Partnerships to build climate resilient health systems for malaria control in Sub-Saharan Africa (SSA) should be harnessed to implement the WHO Operational Framework in SSA. This review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Centre for Reviews and Dissemination (CRD) guidelines. A search strategy was formulated based on the PECOS framework using BOOLEAN operators \"AND\" and \"OR\" for all possible combinations of the following search teams: public-private sector partnerships, public health, and Sub-Saharan Africa. We identified 173 research papers from our database searches, and this systematic review includes 11 articles focusing on the objective of this study. The included studies identified challenges such as ineffective legal and policy frameworks, bureaucracy, limited buy-in and adherence to guidelines by private partners and a lack of systemic integration of climate risk assessments in health planning among others. On the other hand, opportunities lie within the health workforce, essential medicines and technologies, and emergency preparedness and management. These include health workforce education and training through massive open online courses, proper response targeting in partnership with the private sector, and co-production mechanisms for climate change and malaria research. PPPs remain a viable alternative in the adaptation of the WHO Operational Framework despite the challenges they face. This is particularly the case when the technical and financial capacities of the countries in the SSA region are considered. There are lessons to be derived and best practices to be instituted from case studies of previous partnerships, especially in malaria control.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1593923"},"PeriodicalIF":2.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the determinants of uptake and hesitancy in accessing COVID 19 vaccines in Nigeria: a scoping review.","authors":"Chikezie Ifeanyi, Emmanuel Okechukwu, Olushola Tosin, Ichoku Hyacinth, John Ele-Ojo Ataguba, Grace Njeri Muriithi, Daniel Malik Achala, Elizabeth Naa Adukwei Adote, Chinyere Ojiugo Mbachu, Senait Alemayehu Beshah, Chijioke Osinachi Nwosu, John Thato Tlhakanelo, James Akazili, Nyasha Masuka","doi":"10.3389/frhs.2025.1609418","DOIUrl":"10.3389/frhs.2025.1609418","url":null,"abstract":"<p><p>The coronavirus disease (COVID-19) is one of the largest public health threats in recent times, with significant health, economic, and social consequences globally. The WHO reported that over 651 million cases and 6.6 million deaths were attributed to COVID-19 globally. The Nigeria Centre for Disease Control (NCDC) in 2022 revealed that 266,057 cases with 3,155 deaths were reported. All the thirty-six states and the Federal Capital Territory (FCT) of Nigeria were affected, but Lagos and the FCT reported the highest number of cases. However, it is possible that these numbers do not accurately reflect the severity of COVID-19 disease in Nigeria because the country had only tested 5,160,280 people as at 2022, despite a population of around 200 million. Nigeria did not meet its 2021 vaccination target, prompting the need to identify the contextual factors affecting vaccine access and uptake as well as vaccine hesitancy in Nigeria and document the approaches that can be deployed to reduce opposition to vaccination as well as improve advocacy for vaccine equity. This scoping review, conducted using Arksey and O'Malley's framework, aimed to explore the factors influencing COVID-19 vaccine hesitancy and uptake in Nigeria. A comprehensive literature search was conducted across electronic databases, including Google Scholar and PubMed, with studies from Nigeria published in English. The review included 25 studies on vaccine hesitancy, uptake, and willingness to accept COVID-19 vaccination, identifying barriers at the national, community, and individual levels. The results indicated that 90% of the studies showed low vaccine acceptance and uptake, with barriers related to vaccine availability, misinformation, cultural and religious influences, socioeconomic factors, and lack of trust in the health system. Socio-demographic factors such as gender, age, education, and income were identified as key influences. The findings highlight the need for targeted, evidence-based strategies to address vaccine hesitancy, improve vaccine distribution, and engage diverse population groups to enhance vaccination uptake across Nigeria.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1609418"},"PeriodicalIF":2.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12443694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical equipment in the global south: perspective of sustainability and donations.","authors":"Frederik Paustian, Rasmus Gøl, Hannah Wolfe Julsgart, Sofie Bjerre Degn, Andreas Philip Rosenbom, Anton Aaby Henriksen, Liselotte Højgaard","doi":"10.3389/frhs.2025.1638305","DOIUrl":"10.3389/frhs.2025.1638305","url":null,"abstract":"<p><p>Disparities in healthcare infrastructure between the Global South and North continue to affect medical equipment availability, functionality, and sustainability in low- and middle-income countries (LMICs). This study combines a systematic literature review with on-site fieldwork in Ugandan hospitals to assess the current state of medical equipment in LMICs and propose actionable strategies for more sustainable donation practices. Following a systematic literature review, 18 articles were analyzed and categorized according to five research questions addressing sustainability metrics, affordability, recycling practices, systemic barriers, and innovations in medical equipment use. Parallel fieldwork conducted by biomedical engineering volunteers in two Ugandan hospitals documented over 1,400 devices and resulted in the repair of 51 items-generating estimated savings of $102,000. Many devices remained unused due to a lack of spare parts and contextual compatibility. A carbon footprint assessment of donated equipment shipment from Denmark to Uganda further underscored the environmental implications of donation programs. Drawing on literature insights and field observations, this paper proposes a set of eight principles to enhance the sustainability and long-term impact of medical equipment donations. Emphasizing context-aware design, training, maintenance, and donor-recipient collaboration, these recommendations aim to shift donation models toward more resilient and responsible healthcare partnerships.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1638305"},"PeriodicalIF":2.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12443703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting lean healthcare: adopting value stream mapping from manufacturing.","authors":"Ageel Alogla","doi":"10.3389/frhs.2025.1613756","DOIUrl":"10.3389/frhs.2025.1613756","url":null,"abstract":"<p><p>The application of lean thinking in healthcare has gained momentum in recent years, yet its implementation continues to face persistent challenges. Among these, staff resistance and conceptual misalignment between industrial principles and clinical environments remain significant barriers. This study argues that these issues stem not from the failure of lean theory itself, but from a flawed translation of lean tools, particularly Value Stream Mapping (VSM), from manufacturing to healthcare. To address this, we propose a systematic translation model that redefines key VSM elements (e.g., customer, inventory, takt time) in a way that aligns with the operational realities of outpatient care. The model is empirically validated through two case studies conducted in Saudi Arabia: an ophthalmology clinic and a dental clinic. By applying translated VSM tools, both clinics achieved substantial reductions in and patient waiting time, without compromising value-added care. The findings support the efficacy of contextualized lean implementation and provide healthcare managers with a practical framework for operational improvement. This study contributes to bridging the gap between lean theory and its real-world application in clinical settings.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1613756"},"PeriodicalIF":2.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12443820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}