Frontiers in health services最新文献

{"title":"Adoption and acceptability of a perioperative nutrition program among total joint arthroplasty patients.","authors":"Derek S Yocum, Leila Hammond, Emma Housholder, Néma McGlynn, Sara Y Oikawa, Claudia Kabele, Adam Cien, Jeffrey D Yergler","doi":"10.3389/frhs.2025.1555209","DOIUrl":"10.3389/frhs.2025.1555209","url":null,"abstract":"<p><strong>Introduction: </strong>Perioperative nutrition interventions improve postoperative outcomes after total joint arthroplasty (TJA). Despite this improvement, adoption and acceptability of nutrition interventions among orthopedic patients have never been assessed, even though they are key factors in patient adherence and practitioner buy-in. To address this knowledge gap, the adoption and acceptability of a 4-week perioperative nutrition program were explored.</p><p><strong>Methods: </strong>Patients who underwent TJA at a single orthopedic clinic in South Bend, Indiana, USA, were invited to participate. Eligible patients were informed of the nutrition program > 2 weeks prior to their scheduled surgery. Two weeks postoperatively, patients were administered a digital questionnaire that captured their demographic information, whether they purchased the nutrition program or not, reasons for non-participation, and acceptability of the nutrition program among those who participated based on the theoretical framework of acceptability.</p><p><strong>Results: </strong>A total of 341 patients were approached, of which 208 consented. There were no demographic differences between the participants who purchased the nutrition program (105) and those who did not (103). The majority of the participants who purchased the nutrition program (78.7%, <i>n</i> = 85) were satisfied with it, and 65.7% (<i>n</i> = 71) believed it improved their surgical recovery. The most common reason cited for non-participation was cost.</p><p><strong>Conclusion: </strong>A nutrition program, implemented using a pragmatic adjunctive model, was adopted by many of the patients who underwent arthroplasty, regardless of demographics. The nutrition program was generally well-accepted by those who participated in it. Considerations around perceived cost need to be addressed in future implementations of the program.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1555209"},"PeriodicalIF":2.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002053","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":"Adverse event reporting and patient safety: the role of a just culture.","authors":"Augustine Kumah","doi":"10.3389/frhs.2025.1581516","DOIUrl":"10.3389/frhs.2025.1581516","url":null,"abstract":"<p><p>Reporting adverse events is essential for ensuring patient safety and fostering a culture of continuous improvement in healthcare. Adverse events, defined as unintended injuries or complications arising from healthcare management, offer crucial insights into systemic weaknesses that, if addressed, can prevent future harm. However, underreporting such events remains a significant challenge, often driven by fear of punitive actions, reputational damage or legal repercussions. To address these concerns and promote a robust reporting culture, healthcare organisations must adopt a just culture by implementing standardised frameworks for evaluating errors and establishing robust reporting systems. A culture that emphasises accountability and learning over punitive measures. Leadership commitment, psychological safety, and fair accountability are foundational to fostering a just culture in healthcare. While each theme presents specific requirements and challenges, their integration is essential for building a resilient and learning-oriented healthcare system.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1581516"},"PeriodicalIF":2.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002028","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":"Nurse leaders' perceptions of leadership development needs for strengthening the nursing workforce: a South African pilot study.","authors":"Mirriam Matandela, Goitsemang Lucy Chisale, Vhothusa Edward Matahela","doi":"10.3389/frhs.2025.1634563","DOIUrl":"10.3389/frhs.2025.1634563","url":null,"abstract":"<p><strong>Background: </strong>Nurses are central to South Africa's healthcare system, yet the sector faces ongoing challenges, including workforce shortages, high workloads, limited career progression, and weak institutional support. These issues are exacerbated by the absence of a structured leadership development framework. In response, the national Department of Health, through the South African Nursing Leadership Initiative, launched a pilot study to explore nurse leaders' perceptions of leadership development needs prior to the development of a national Nursing Leadership Competency Framework. This study explored nurse leaders' perceptions of the leadership capacity required to strengthen the nursing workforce and support national health priorities.</p><p><strong>Methods: </strong>A qualitative, exploratory study was conducted between May and July 2024, involving 153 purposively selected nurse leaders from four provinces. Data were collected through structured group narrative sessions, using semi-structured questionnaires aligned with global frameworks. A deductive thematic narrative analysis guided by Braun and Clarke's six-phase framework (2006) was employed to identify themes.</p><p><strong>Results: </strong>Three central themes emerged consistently across the pilot provinces. (1) <i>Workforce planning and career pathway development</i> revealed persistent nursing shortages and limited opportunities for career advancement. (2) <i>Capacity building through continuing professional development</i> highlighted the need for structured in-service education and leadership training to address skills gaps. (3) <i>Organisational support and leadership for retention</i> underscored high workloads, inadequate institutional support and the absence of psychological safety, all contributing to poor retention and morale.</p><p><strong>Conclusion: </strong>This pilot study provides contextual insights into the leadership development needs of a limited group of nurse leaders, which will inform the refinement of data collection tools and the design of a larger, national study. The findings are not generalisable but offer valuable direction for developing a contextually grounded Nursing Leadership Competency Framework and supporting strategic leadership capacity-building aligned with South Africa's health system strengthening goals.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1634563"},"PeriodicalIF":2.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002005","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 contribution of a person-centred model of Lean Six Sigma to the development of a healthful culture of health systems improvement.","authors":"Seán Paul Teeling, Deborah Baldie, Ailish Daly, Anne Marie Keown, Aileen Igoe, Ciara Dowling, Martin McNamara","doi":"10.3389/frhs.2025.1621233","DOIUrl":"10.3389/frhs.2025.1621233","url":null,"abstract":"<p><strong>Background: </strong>A failure to distinguish between person-centredness, person-centred care, and person-centred cultures can result in improvement initiatives focusing solely on improvement initiative metrics and outcomes, excluding the authentic experiences of patients and staff. Building on the foundational work of Dewing and McCormack, we have designed, piloted, and implemented the Person-centred Lean Six Sigma (PCLSS) model in public and private acute and community healthcare settings across Ireland. This model uses Lean Six Sigma, a widely adopted improvement methodology, through a person-centred lens with which improvement practitioners and healthcare staff can inspect their Lean Six Sigma practice and critically evaluate whether, to what extent, and how it is synergistic with person-centred approaches.</p><p><strong>Aim: </strong>This paper explores the deployment of the PCLSS model across four clinical study sites and examines its alignment with McCance and McCormack's conceptual work on healthful cultures, evaluating its contribution to creating cultures that support sustainable improvement, compassion, and respect.</p><p><strong>Methods: </strong>The PCLSS model was embedded within a university-accredited education programme for healthcare staff. The model was applied across four distinct healthcare settings in Ireland: a public acute teaching hospital, a private full-service acute hospital, an integrated ophthalmology service bridging hospital and community care, and a public rehabilitation hospital. A case study methodology was used to examine implementation and impact.</p><p><strong>Results: </strong>Across all four sites, the PCLSS model facilitated improvements in operational efficiency, staff and patient engagement, interprofessional collaboration, and reflective practice. The model supported leadership at all levels, fostered sustainable change, and successfully mapped onto key domains associated with healthful cultures, as articulated in the work of McCance and McCormack.</p><p><strong>Conclusion: </strong>The PCLSS model represents a sustainable, values-based approach to improvement that aligns operational excellence with person-centred principles. Its application contributes meaningfully to the development of healthful cultures in healthcare organisations.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1621233"},"PeriodicalIF":2.7,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994651","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":"Editorial: Climate change, human health, and health systems.","authors":"Munyaradzi Saruchera, Morenike Oluwatoyin Folayan, Bethuel S Ngcamu, Walter Musakwa, Margaret Kaseje, Godfred O Boateng","doi":"10.3389/frhs.2025.1615206","DOIUrl":"10.3389/frhs.2025.1615206","url":null,"abstract":"","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1615206"},"PeriodicalIF":2.7,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980862","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":"Relationship between retention intention, perceived organizational support, and medical narrative ability among nurses: a cross-sectional multi-center study.","authors":"Yanjia Li, Rong Zhang, Limei Kang, Guoting Ma","doi":"10.3389/frhs.2025.1648464","DOIUrl":"10.3389/frhs.2025.1648464","url":null,"abstract":"<p><strong>Background: </strong>MNA is widely regarded as an important factor in promoting the construction of humanistic hospitals. Nurses are the medical professionals who have the highest participation in the clinical practice of narrative medicine and humanistic nursing in hospitals. Therefore, it is crucial to study the impact of nurses' RI and POS on MNA.</p><p><strong>Objectives: </strong>This study aims to determine the effects of nurses' perceived organizational support (POS) and retention intention (RI) on nurses' medical narrative ability (MNA) and to reveal the mediating role of RI in the possible impact.</p><p><strong>Methods: </strong>A cross-sectional descriptive correlational study was performed. Survey data were gathered from 1,831 practicing nurses working in eight tertiary general hospitals across China. The questionnaire was divided into four sections: a sociodemographic characteristics survey, a medical narrative ability scale, a perceived organizational support scale, and a Chinese questionnaire for nurses' intention to remain employed. Data analysis was conducted using SPSS 27.0.</p><p><strong>Results: </strong>The survey results show that the relationships among RI, POS, and MNA are all significant, with correlation coefficients ranging from 0.344 to 0.468. The indirect effect of POS on MNA is 1.267, accounting for 29.12% of the cumulative effect.</p><p><strong>Conclusion: </strong>This study reveals that nurses' POS not only directly enhances their MNA but also indirectly has a profound impact on this ability through the mediating mechanism of the RI. This finding indicates that nursing managers both domestically and internationally should pay close attention to nurses' perception levels of organizational support and their RI, and formulate precise and effective intervention strategies, thereby using this as a potential organizational management approach to enhance nurses' MNA.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1648464"},"PeriodicalIF":2.7,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981046","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":"Universal health coverage in Lebanon: agenda setting using Kingdon's model and a proposed legal framework for revenue allocation.","authors":"Joseph Mouawad, Maria Rita Lteif, Wadih Mina, Rita Karam","doi":"10.3389/frhs.2025.1627319","DOIUrl":"10.3389/frhs.2025.1627319","url":null,"abstract":"<p><strong>Background: </strong>Health systems globally aim for Universal Health Coverage (UHC), however progress toward UHC remains challenging in many countries. Despite previous unsuccessful parliamentary attempts to secure national commitment to a UHC plan in Lebanon, a renewed and revised effort is currently being made by a dedicated parliamentary committee. This study has two main objectives: to examine the emergence of the UHC bill as a priority on the Lebanese policy agenda using John Kingdon's Framework; and (2) to conduct a policy analysis using Bardach and Patashnik's eight-step framework to identify the most suitable funding option for the proposed UHC program.</p><p><strong>Methods: </strong>Two policy analysis frameworks were applied: John Kingdon's model, commonly used to study agenda setting, and Bardach and Patashnik's eight-step framework, designed to evaluate policy options and recommend evidence-based solutions. A qualitative document analysis was conducted using the READ approach drawing on secondary literature sources. Data triangulation was also used to ensure consensus and accuracy.</p><p><strong>Results: </strong>The document analysis identified the emergence of a window of opportunity for the UHC bill as the three streams aligned: mounting public pressure, the formation of a parliamentary committee, and evident political receptiveness through the involvement of multiple parties. Bardach & Patashnik's policy analysis framework identified earmarked excise taxes as the most suitable policy alternative for financing UHC in Lebanon.</p><p><strong>Conclusion: </strong>This study explains the emergence of an updated UHC bill on the Lebanese policy agenda while conducting a policy analysis of the earmarked excise taxed to fund UHC. To overcome anticipated challenges a legislative framework must be established to ensure transparency in funding and government accountability.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1627319"},"PeriodicalIF":2.7,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980958","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 Family Wellness Program: a bench to bedside translation of behavioral and social science research into a clinical program for intimate partners of warfighters following traumatic brain injury.","authors":"Tracey A Brickell, Megan M Wright, Samantha M Baschenis, Rael T Lange, Jamie K Sullivan, Louis M French","doi":"10.3389/frhs.2025.1575781","DOIUrl":"10.3389/frhs.2025.1575781","url":null,"abstract":"<p><p>This report details a bench to bedside translation of behavioral and social science research into a clinical program as a result of a collaboration between two United States Defense Health Agency Centers of Excellence for warfighter traumatic brain injury (TBI) and brain health. Identifying a gap in health-related quality of life (HRQOL) measures, our team instigated a 7-year multisite effort to validate and develop generic and caregiver specific HRQOL domains for family members of warfighters and civilians with a TBI using state-of-the-science measurement development standards; the <i>Traumatic Brain Injury Caregiver Quality of Life (TBI-CareQOL)</i> measurement system. The TBI-CareQOL was integrated into the Defense and Veterans Brain Injury Center-Traumatic Brain Injury Center of Excellence <i>15-Year Longitudinal TBI Study</i> designed to address four elements in a Congressional mandate (NDAA FY2007 Sec721 Public Law 109-364). Based on findings from the 15-Year Longitudinal TBI study and larger body of related literature demonstrating the bidirectional associations between warfighter neurobehavioral outcomes and family distress, relevant TBI-CareQOL measures were integrated into the <i>Family Wellness Program (FWP)</i> for intimate partner (IP) beneficiaries of warfighters with TBI in treatment for chronic neurobehavioral symptoms across the Defense Intrepid Network for Traumatic Brain Injury and Brain Health (DIN). The FWP screens IPs for clinically elevated HRQOL symptoms with clinical follow up offered in alignment with operations at each DIN treatment center and military base. In July 2024, the FWP was launched at the National Intrepid Center of Excellence at Walter Reed National Military Medical Center, and is currently expanding across the DIN.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1575781"},"PeriodicalIF":2.7,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981030","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":"Primary care stability as a social determinant.","authors":"Waseem Jerjes","doi":"10.3389/frhs.2025.1646932","DOIUrl":"10.3389/frhs.2025.1646932","url":null,"abstract":"","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1646932"},"PeriodicalIF":2.7,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981023","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 of learning into person-centred practice: evidence of impact from community nursing preparation programmes.","authors":"Vaibhav Tyagi, Julie Churchill, Caroline Dickson","doi":"10.3389/frhs.2025.1598699","DOIUrl":"10.3389/frhs.2025.1598699","url":null,"abstract":"<p><strong>Introduction: </strong>There has been a global move towards personalising and \"humanising\" healthcare and promoting caring cultures. Education is addressing this agenda by incorporating person-centred principles into teaching and learning. The aim of this research was to explore the implementation of person-centred learning into healthcare practice. More specifically, this study aims to explore community nurses' implementation of learning about person-centredness in their practice and to demonstrate the impact of person-centred curriculum.</p><p><strong>Methods: </strong>A cross-sectional quantitative survey design was used with community nursing graduates and current students who engaged with person-centred curricula.</p><p><strong>Results: </strong>Significant improvements were found in three constructs of person-centred practice-<i>clarity of beliefs and values, knowing self and developed interpersonal skills</i>.</p><p><strong>Discussion: </strong>These findings provide support for the development of pre-requisites of person-centred practice, rather than person-centred processes in pre-registration curricula. With key pre-requisites for person-centred practice such as leadership attributes of knowing self and of advanced communication skills, learners and graduates will be able adopt healthful leadership practices which are vital in developing others and in creating person-centred cultures.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1598699"},"PeriodicalIF":2.7,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981014","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}