An in-depth discussion and illustration of partial least squares structural equation modeling in health care

Leverage machine learning to identify key measures in hospital operations management: a retrospective study to explore feasibility and performance of four common algorithms

BACKGROUND

Measures in operations management are pivotal for monitoring and assessing various aspects of hospital performance. Existing literature highlights the importance of regularly updating key management measures to reflect changing trends and organizational goals. Advancements in machine learning (ML) have presented promising opportunities for enhancing the process of updating operations management measures. However, their specific application and performance remain relatively unexplored. We aimed to investigate the feasibility and effectiveness of using common ML techniques to identify and update key measures in hospital operations management.

METHODS

Historical data on 43 measures on financial balance and quality of care under 4 categories were retrieved from the BI system of a regional health system in Central China. The dataset included 17 surgical and 15 non-surgical departments over 48 months. Four common ML techniques, linear models (LM), random forest (RF), partial least squares (PLS), and neural networks (NN), were used to identify the most important measures. Ordinary least square was employed to investigate the impact of the top 10 measures. A ground truth validation compared the ML-identified key measures against the humanly decided strategic measures from annual meeting minutes.

RESULTS

For financial balancing, inpatient treatment revenue was an important measure in 3/4 years, followed by equipment depreciation costs. The measures identified using the same technique differed between years, though RF and PLS yielded relatively consistent results. For quality of care, none of the ML-identified measures repeated over the years. Those consistently important over four years differed almost entirely among four techniques. On ground truth validation, the 2016-2019 ML-identified measures were among the humanly identified measures, with the exception of equipment depreciation from the 2019 dataset. All the ML-identified measures for quality of care failed to coincide with the humanly decided measures.

CONCLUSIONS

Using ML to identify key hospital operational measures is viable but performance of ML techniques vary considerably. RF performs best among the four techniques in identifying key measures in financial balance. None of the ML techniques seem effective for identifying quality of care measures. ML is suggested as a decision support tool to remind and inspire decision-makers in certain aspects of hospital operations management.

Insights from the COVID-19 perspective on the necessity of corporate social responsibility in times of crisis in the context of Pakistan

In light of the COVID-19 pandemic, there has been a notable increase in global awareness among businesses and consumers regarding environmental preservation and health concerns. The degree to which individuals identify with an organization is influenced by the appeal of its organizational identity, which aids in fulfilling important self-definitional needs. Nevertheless, there remains a limited understanding regarding the underlying factors that contribute to the phenomenon of firm identity attraction (IA) within the framework of consumer-business interactions. This study presents a validated framework that examines the antecedents of identity attraction, with COVID-19 being considered as a moderator. The framework is developed based on established theories of social identity and organizational identification. The study in Pakistan's cities utilized a questionnaire survey as its primary research method, while the findings were evaluated through the application of structural equation modelling. The results of our study indicate that the impact of corporate social responsibility (CSR) on firm Identity Attraction (IA) is significantly more pronounced. Although the impact of COVID-19 on the intention to purchase remains unaffected, it does play a favorable role in moderating the influence of CSR on the attraction towards brand.

Is knowledge liberating? The role of knowledge behaviors and competition on the workplace happiness of healthcare professionals

PURPOSE

The purpose of this paper is to highlight the joint impact of competitive culture and knowledge behaviors (sharing, hoarding and hiding) on workplace happiness among healthcare professionals. It addresses a literature gap that critiques the development of happiness programs in healthcare that overlook organizational, social and economic dynamics. The study is based on the Social Exchange Theory, the Conservation of Resources Theory and the principles of Positive Psychology.

DESIGN/METHODOLOGY/APPROACH

The study analyzes a linear relationship between variables using a structural equation model and a partial least squares approach. The data are sourced from a survey of 253 healthcare professionals from Portuguese healthcare organizations.

FINDINGS

The data obtained from the model illustrate a positive correlation between competitive culture and knowledge hoarding as well as knowledge hiding. Interestingly, a competitive culture also fosters workplace happiness among healthcare professionals. The complex relationship between knowledge behaviors becomes evident since both knowledge hoarding and sharing positively affected these professionals' workplace happiness. However, no direct impact was found between knowledge hiding and workplace happiness, suggesting that it negatively mediates other variables.

ORIGINALITY/VALUE

This research addresses a previously identified threefold gap. First, it delves into the pressing need to comprehend behaviors that enhance healthcare professionals' workplace satisfaction. Second, it advances studies by empirically examining the varied impacts of knowledge hiding, hoarding and sharing. Finally, it sheds light on the repercussions of knowledge behaviors within an under-explored context - healthcare organizations.

A cross-sectional study on exploring the antecedents of patient's revisit intention: Mediating role of trust in the hospital among patients in India

BACKGROUND

In the healthcare domain, patients' trust in the hospital plays an instrumental role in determining the behavioral intention of the patient. This article attempts to investigate the impact of service quality perception on behavioral intention with the mediating effect of trust in the hospital and patient satisfaction.

METHODS

This research was carried out in multispecialty hospitals located in Bangalore Urban and Mysore districts of Karnataka during August 2021. This was a questionnaire-based study and the sample size was 242. Statistical Package for the Social Science (SPSS) 27.0 and SmartPLS 3.0 software was used to analyze the data.

RESULTS

The findings revealed that perceived service quality significantly influences trust through patient satisfaction (observed partial mediation) and patient satisfaction significantly impacts behavioral intention through trust (observed partial mediation).

CONCLUSION

This study empowers hospital managers to understand the factors influencing behavioral intention. Healthcare professionals must ensure that good quality service is delivered to enhance patient satisfaction and trust in adverse services, which influence behavioral intention among the patients.

Environmental and health values, beliefs, norms and compatibility on intention to adopt hydroponic farming among unemployed youth

The objective of this study was to examine the relationships among environmental and health values, ecological worldview, perception of consequences, the ascription of responsibility, and personal norms in the context of the value-belief-norm (VBN) model and how compatibility influences the intentions and behaviors of Chinese youth regarding the use of hydroponic farming technology. The study employed a survey questionnaire to collect data from the target population. The sample size was determined through a power analysis to ensure sufficient statistical power for the analysis. A total of 727 potential respondents' responses were analyzed using SmartPLS (4.0) to perform structural equation modeling. The results confirmed that environmental, emotional, and health values significantly associated with individuals' ecological worldviews. There was an interconnection between ecological worldview, awareness of consequences, and ascription of responsibility, and all three significantly influenced personal norms. The key determinants of the intentions and behaviors to adopt hydroponic farming technology are personal norms and technology compatibility. Therefore, to promote and motivate the interest and intention to use hydroponics among unemployed youth, government agencies, and related companies should focus on providing technology-related and pro-environmental information and training. This is expected to increase the acceptance and awareness of hydroponics among this group, thus increasing the adoption rate of hydroponics.

Which qualities should built environment possess to ensure satisfaction of higher-education students with remote education during pandemics?

The built environment may be considered a complex system comprising several parts (including people, organizations, and physical structures). Since the emergence of the COVID-19 virus in recent years, there has been an explosion in the usage of mobile learning applications for classroom instruction. Research on the diffusion of mobile learning is lacking. This study examines the perceptions and experiences of many aspects of online education from the viewpoint of Chinese HEIs and university students who shifted to online modes of instruction during the COVID-19 outbreak. This research aimed to determine whether or not college students were happy with the resources available to them, how their teachers communicated with them, how they were evaluated, and the conditions in which they studied at home. It also looked at the pros and cons of online learning from the students' points of view. For this study, researchers opted for a cross-sectional survey using an online questionnaire. Information was gathered from 450 students from different Chinese tertiary institutions. To this end, we reflect on the experiences and perspectives of postgraduate students in urban design and discuss the results of an online survey conducted during the 2021-2022 academic year's subject delivery period, which included activities such as assessment, feedback, field study visits, workshops, and the use of digital platforms. PLS-SEM, which stands for partial least square structural equation modeling, is used in order to evaluate the proposed model. Therefore, the findings show that the research model offered for this investigation could explain the diversity in the actual use of mobile learning systems. This would provide helpful insight into the effect of educational, environmental, and quality factors on the actual use of remote education systems. It was shown that quality concerns acted as a mediator between institutional policy, change management, and the implementation of mobile learning systems in actual classrooms. The findings also indicate that the level of pleasure students feel acts as a moderating factor between the degree to which the mobile learning system is used and its overall level of quality. According to the findings of these studies, academic institutions may enhance their use of mobile learning applications and get more benefits from these systems if they adhere to the suggestions stated in these studies.

Relationship chains of subhealth physical examination indicators: a cross-sectional study using the PLS-SEM approach

Subhealth is a transitional state between health and disease, and it can be detected through routine physical check-ups. However, the complexity and diversity of physical examination items and the difficulty of quantifying subhealth manifestations are the main problems that hinder its treatment. The aim of this study was to systematically investigate the physical examination performance of the subhealthy population and further explore the deeper relationships between indicators. Indicators were obtained for 878 subjects, including basic information, Western medicine indicators, inquiries of traditional Chinese medicine and sublingual vein (SV) characteristics. Statistical differences were analysed using R software. To explore the distribution of symptoms and symptom clusters in subhealth, partial least squares-structural equation modelling (PLS-SEM) was applied to the subhealth physical examination index, and a structural model was developed to verify whether the relationship chain between the latent variables was reasonable. Finally, the reliability and validity of the PLS-SE model were assessed. The most common subclinical clinical symptoms were limb soreness (37.6%), fatigue (31.6%), shoulder and neck pain (30.5%) and dry eyes (29.2%). The redness of the SV in the subhealthy group was paler than that in the healthy group (p < 0.001). This study validates the establishment of the directed acyclic relationship chain in the subhealthy group: the path from routine blood tests to lipid metabolism (t = 7.878, p < 0.001), the path from lipid metabolism to obesity (t = 8.410, p < 0.001), the path from obesity to SV characteristics (t = 2.237, p = 0.025), and the path from liver function to SV characteristics (t = 2.215, p = 0.027). The innovative application of PLS-SEM to the study of subhealth has revealed the existence of a chain of relationships between physical examination indicators, which will provide a basis for further exploration of subhealth mechanisms and causal inference. This study has identified the typical symptoms of subhealth, and their early management will help to advance the treatment of diseases.

Assessing green financing with emission reduction and green economic recovery in emerging economies

The aim of the study is to assess the role of green financing on carbon emission reduction and green economic recovery in emerging economies context. The BCC DEA technique of data envelopment analysis (DEA) is used to examine the nexus among variables by applying small input-output estimation parameters. Researchers found that green financing strategies like government subsidies and tax refunds for green financing are effective in cutting carbon emissions in developing nations. As a result, a panel of data from 2016 to 2020 is employed. Green financing measures assist reduces carbon emissions and prolong the green economic rebound, according to our research. Renewable energy companies had better ranges of total investment efficiency and size efficiency, and their levels of green economic recovery promotion were more than 0.457% percent, with a reduction in carbon emissions of 29.7 percent in developing countries backed by present government subsidies of 16 percent and taxes rebates of 11 percent. Green financing policies have a favorable impact on the green economy's revival. The study's policy implications include that green financing policies be implemented successfully to reduce carbon emissions more efficiently and to make climate change beneficial to countries in order to promote economic recovery over time.

Trend in the admissions of patients with non-COVID-19 respiratory symptoms during COVID-19 pandemic and its impact on hospital finances in surabaya, Indonesia

Background

COVID-19 cases surge, it has a crucial impact on healthcare systems, with rapidly increasing demand for healthcare resources in hospitals and intensive care units (ICUs) in Indonesia and worldwide. It is necessary to quantify the extent to which the effects of the COVID-19 pandemic on the hospital admissions, and clinical and financial outcomes of patients with non-COVID-19 respiratory symptoms.

Objective

To determine whether the COVID-19 pandemic changed the hospitalisation of child and adult patients with non-COVID-19 respiratory conditions and whether these changes affected the patient's disease condition, clinical outcomes, and hospital finances.

Methods

A retrospective cohort study was conducted from May 1, 2018 (before the COVID-19 pandemic) until December 31, 2021. Total sampling was done to compare hospital admission of patients with non-COVID-19 respiratory symptoms before versus during the COVID-19 pandemic. The results were analyzed using SPSS 26.0 and SmartPLS.v.3.2.9.

Results

There was a reduction in hospitalisations for respiratory disorders unrelated to COVID-19 during the pandemic by 55.3% in children and 47.8% in adult patients. During the pandemic, the average hospital revenue per patient of child and adult patients increased significantly, but the profit per patient decreased. Pathway analysis showed that in children, the COVID-19 Pandemic changed disease severity and complexity (β = 0.132, P < 0.001), as well as clinical outcomes (β = 0.029, P < 0.05). In adults, the COVID-19 pandemic improves disease severity and complexity (β = -0.020, P < 0.001), as well as clinical outcomes (β = -0.013, P < 0.001). COVID-19 pandemic increases care charges (in children with β = 0.135, P < 0.001; and in the adult patients with β = 0.110, P < 0.001), worsens hospital financial outcomes relating to child (β = -0.093, P < 0.001) and adult patient (β = -0.073, P < 0.001). In adult patients, seasonal variations moderate the impact of the COVID-19 pandemic on improving disease conditions (β = -0.032, P=<0.001). The child structural model effectively predicted clinical outcomes (Q² = 0.215) and financial outcomes (Q² = 0.462). The adult structural model effectively predicted clinical outcomes (Q² = 0.06) and financial outcomes (Q² = 0.472).

Conclusion

The conclusions are that the number of non-COVID respiratory patients decreased during the COVID-19 pandemic (47.8% in adult patients, 55.3% in child patients). Disease severity and complexity increased in child patients but decreased in adult patient. Costs of care and insurance payments increased. Since the insurance payments did not increase as much as the cost of care, hospital profit decreased.

Adaptation of families of adult patients with brain tumor: Partial least squares structural equation modeling

Brain tumor patients experience physical, psychological, social, and cognitive changes. These changes are challenging for both the patients and their families. These patients and their families need to adapt together on the cancer treatment path. This study aimed to identify the factors affecting adaptation in families of adult patients with brain tumors. A quantitative, cross-sectional study of 165 families of adult patients with primary brain tumors was conducted using a self-administered questionnaire. Partial least squares structural equation modeling was used to test a hypothetical model. The results showed that family stress, family functioning, and family resources influenced on family adaptation in families of adult patients with primary brain tumors. Among these factors, family resources were identified to be the strongest factor associated with family adaptation. The results of this study may be utilized as a theoretical basis in nursing to improve the family adaptation of patients with brain tumors. Regarding nursing practices, the results suggest that nurses should provide family-centered nursing interventions and promote family resources to help brain tumor patients and their families to adapt.

Pediatric Residency Training amid the COVID-19 Pandemic: Exploring the Impact of Supervision and Clinical Practice Guidelines on Clinical and Financial Outcomes

Objective

This study is aimed at calculating the magnitude of the effect of clinical practice guidelines (CPG) and supervision in inhibiting the negative impact of the COVID-19 pandemic on clinical and financial outcomes of non-COVID-19 inpatient care by pediatric residents in academic medical center (AMC) hospitals during the COVID-19 pandemic.

Methods

The cohort retrospective study was conducted. This study collected patient data from pediatric residency programs. A research cohort consisted of non-COVID-19 pediatric patients at Dr. Soetomo General Academic Hospital. This study compared the subgroup of patients treated during the pandemic with those treated before the pandemic. The results were analyzed using SPSS 26.0 and Smart-PLS.

Results

There was a 41.4% decrease in pediatric inpatients during the pandemic with an increased severity level and complexity level, a reduction of 7.46% availability of supervisors, an increase of 0.4% in readmission < 30 days, an increase of 0.31% in-hospital mortality, an increase the total costs of care, and a decrease of insurance claim profit. CPG did not moderate the effect of the COVID-19 pandemic on the clinical outcomes (β = -0.006, P = 0.083) but moderated the financial outcomes (β = -0.022, P = 0.000), by reducing the total cost of care and increasing insurance claim profit. Supervision moderated the effect of the COVID-19 pandemic on the clinical outcomes (β = 0.040, P = 0.000) by increasing aLOS and on the financial outcomes (β = -0.031, P = 0.000) by reducing the total cost of care and increasing insurance claim profit. This study model had a 24.0% variance of explanatory power for clinical outcomes and 49.0% for financial outcomes. This study's structural model effectively predicted clinical outcomes (Q 2 = 0.238) and financial outcomes (Q 2 = 0.413).

Conclusion

Direct supervision inhibited the negative impact of the COVID-19 pandemic on both clinical and financial outcomes of non-COVID-19 inpatient care by pediatric residents, while CPG only inhibited the negative impact on financial outcomes. Implication of This Study. In a disaster, the availability of CPG and direct supervision makes AMC hospitals able to inhibit the negative impact of disasters on clinical and financial outcomes.

Organizational performance assessment based on psychological empowerment and employee engagement: PCA-DEA-SEM approach

Purpose

This study aims to examine performance assessment of organizational units through psychological empowerment (PE) and employee engagement (EE) approach and whether this relationship differs among efficient and inefficient organization units.

Design/methodology/approach

This study drew on merging the principal component analysis (PCA), data envelopment analysis (DEA) and partial least square-multigroup analysis (PLS-MGA) to benchmark the performance of organizational units affiliated with Zagazig University in Egypt using PE dimensions as inputs and EE as output. Besides investigating whether PE inputs have the same effect among efficient and inefficient units.

Findings

Performance assessment based on independent data showed that all the investigated organizational units are not at the same efficiency level. The results revealed that there are eight efficient units versus seven inefficient ones. Moreover, PLS-MGA results demonstrated that no significant differences concerning the impact of PE inputs on EE between efficient and inefficient units groups. Nevertheless, the effect of these inputs was slightly higher in the former.

Originality/value

Studies on EE performance in the service sector are scarce in the literature, this study is a novel contribution of exploring EE efficiency in Egypt as a developing economy. Specifically, using the PCA-DEA-structural equation modeling approach.

Impact of COVID-19 on psychological distress among SME owners in Ghana: Partial least square-structural equation modeling (PLS-SEM) approach

A critical part of the national economy is small and medium enterprises (SMEs). SME owners are vital contributors to the overall economy. Due to their limited capital and assets, they are more vulnerable. In comparison to their contribution, the value of assessing SME owner's depression, anxiety, and mental stress has been very minimal during the COVID-19 outbreak. Firms were forced to close due to lockdown, and they faced substantial business losses. Thus, this study aims to investigate SME owners' psychological distress due to business losses during this pandemic. The study used psychological parameters: Depression, Anxiety, Stress Scale-21 (DASS-21) to examine SME owners' psychological distress. A total number of 217 owners were surveyed through a judgmental sampling technique using a structured questionnaire. Data were analyzed employing partial least square-based structural equation modeling (PLS-SEM). The findings showed that DASS-21 parameters and fear of business loss affected psychological distress. Besides, fear of business loss increases psychological distress, whereas government support lessens the distress. Theoretically, this study extended the scope of DASS-21 scale and contributed to the literature of psychology. In terms of policy implications, this study provides useful information for government, policymakers, and SME owners about the effects mentioned above.

Exploring enablers of modularity in healthcare service delivery

Purpose

This paper explores the enablers of modular healthcare services.

Design/methodology/approach

A survey-based approach was adopted with specialised hospitals as the unit of analysis. A structural model was developed based on a literature review and assessed using a cross-sectional research design. A 23-indicator questionnaire was circulated among service providers in the healthcare system across India, and 286 valid responses were received. The data were analysed using partial least squares-structural equation modeling (PLS-SEM).

Findings

The results reveal that professional competence, technological versatility, clear division of tasks, channelised flow of information and professional autonomy act as enablers that may drive modular service delivery.

Research limitations/implications

By examining service providers' perspectives, this paper highlights the influence of the identified enablers on modular service delivery in healthcare organisations.

Practical implications

For practitioners, the study provides suggestions for designing patient-centric healthcare services via modular healthcare delivery. The identified structural relationships can facilitate immediate corrective actions and the formulation of future policies. The findings will help practitioners foresee opportunities for patient participation in value co-creation, meet patients' varying needs, decompose service offerings, mix and match components develop sets of rules as interfaces between service modules and design service packages on an ongoing basis.

Social implications

This study underscores the emergence of patient-centric care and may aid the design of processes that deliver health to the patient as a person.

Originality/value

This paper identifies and empirically validates relationships between healthcare service delivery processes and modular service delivery.

The Effects of Transformational Leadership on Organizational Performance: Testing the Mediating Effects of Knowledge Management

Transformational leadership is a sustainable and exemplary form of leadership that liberates subordinates’ ideas, enables subordinates to view problems from a different perspective, helps adaptation to changing environments, and increases Human Resources Management effectiveness in public and service institutions. The effects of transformational leadership on organizational performance by means of knowledge management have been examined in this study on the northern Cyprus Security Forces. In addition, the study aims to analyze the relationships between transformational leadership, knowledge management, organizational performance, job satisfaction, organizational learning, and knowledge creation processes. The questionnaire was conducted in three different periods using a time-lag method, and data were collected from 1229 employees for this study. The collected data were analyzed using structural equation modeling (Lisrel 8.54). The findings of the research include 17 hypotheses that were supported, and 1 hypothesis that was not. In addition, it was determined that organizational learning, knowledge management, and job satisfaction mediate the effect of transformational leadership on organizational performance.

Perceived characteristics of outpatient appointment scheduling association with patient satisfaction and treatment adherence: An innovation theory application

BACKGROUND

Despite the growing interest in Appointment scheduling (APS) in hospitals of developing countries, empirical assessment of their effectiveness in improving patients' experiences and adherence to treatment remains limited. We drew on the attributes of an innovation theory to hypothesize and test the extent to which perceived attributes of APS: relative advantage, compatibility, and complexity influences patient satisfaction and treatment adherence in a neurology clinic of a large Teaching Hospital in Ghana.

METHODS

A structured questionnaire was used to collect cross-sectional data from a sample of 295 scheduled patients visiting the clinic for follow-up care. Partial Least Squares Structural Equation Modeling (PLS-SEM) was used to analyze the hypothesized direct relationships of the APS attributes with patient satisfaction and treatment adherence, and the moderating effect of cordial doctor-patient communication in the relationships.

RESULTS

While the compatibility of APS with patient preference was positively associated with patient satisfaction (p < 0.01) and adherence to treatment (p < 0.01), the reverse was observed for complexity of the APS system (p < 0.01). We also found statistically significant relationship of patient satisfaction with treatment adherence (p < 0.01) which was positively moderated by cordial doctor-patient communication.

CONCLUSION

Findings suggest that making the APS system more compatible with patient preference can greatly improve upon patient experience satisfaction and adherence to medical treatment for effective therapeutic outcomes.

PRACTICE IMPLICATION

In the light of its benefits to patient care and outcomes, APS should be given priority over walk-in services in specialty clinics of developing countries.

The nexus between entrepreneurial orientation and performance: enabling roles of absorptive capacity

Purpose

Developing countries’ economic growth very much depend on the successful performance of entrepreneurial-oriented firms. Entrepreneurial orientation (EO) is a valuable conjecturer of firm success. This study mainly focuses on analyzing the effect of EO on the firm performance (FP) with the mediating role of absorptive capacity (ACAP).

Design/methodology/approach

To test the hypothetical model, we collected 226 valid responses from senior managers of small and medium enterprises (SMEs). The structural equation modeling technique is performed and research hypotheses are validated.

Findings

The findings show that the strong causal relations exit between EO, ACAP and FP. In brief, EO was found to be a predictor of ACAP, and ACAP has a strong positive impact on FP. Moreover, ACAP substantiated to be a mediator between EO and FP.

Research limitations/implications

A notable ramification of this finding is that for SMEs to enhance their performance via EO, the presence of ACAP as a mediator is essential.

Practical implications

The findings of this study can be used as a basis to consider EO to increase firms' level of ACAP and to enhance FP. As a whole, the findings offer pragmatic insights for SMEs and pertinent stakeholders.

Originality/value

So far, little is known about the interrelationship between EO, ACAP and FP. Importantly, the mediating role of ACAP between EO and FP has remained unexplored. This study fills this gap in the existing literature.

Do Good, Have Good: A Mechanism of Fostering Customer Pro-Environmental Behaviors

This paper aims to investigate the role of corporate social responsibility (CSR) in fostering customer’s pro-environmental behavior (PEBs) through customer engagement (CE). Data collected from the hotel customers were analyzed through structural equation modeling. The present research findings reveal the significant role of CSR activities in positively influencing customer PEBs. Moreover, the results also suggest the mediation of CE in the relationship between CSR and customer PEBs. The current research findings offer significant implications that can be employed in developing a result-oriented marketing strategy in CSR activities that contribute to environmental protection and sustainability.

Unraveling the Effects of Ethical Leadership on Knowledge Sharing: The Mediating Roles of Subjective Well-Being and Social Media in the Hotel Industry

Given the pivotal function of ethical leadership (EL) in the hospitality industry, this study explains how moral guidance can help to reduce mental stress. The modern complex and hectic working style of organizations demands ethical conduct, in order to sustain the positive behavior of employees for knowledge sharing (KS). For this reason, in this study, we restrict our awareness to the usage of social media (SM) for social identity and aspects of subjective well-being (SWB) for happiness intensity. The time-lag method is applied for data collection from 406 supervisors and subordinates of the hotel industry in Pakistan. Partial least squares structural equation modeling (PLS-SEM) and bootstrapping are utilized to scan the data. The results of the current study demonstrate that ethical leadership provides motivational strength for knowledge sharing amongst employees. Moreover, the serial mediation effects of subjective well-being and social media boost knowledge sharing by the induction of ethical values. Our findings indicate that knowledge sharing is an important product of subjective well-being and social media. Therefore, we recommend that managers focus on ethical leadership values and employee well-being (e.g., life satisfaction), as well as highlight the individuality of employees to promote knowledge sharing. The presented research adds to the literature by establishing a new connection between ethical leadership and knowledge sharing by opening the black box of contextual (i.e., ethical leadership) and developmental (i.e., subjective well-being and social media) factors.

Future-Oriented Happiness: Its Nature and Role in Consumer Decision-Making for New Products

Cognitive evaluations only partially explain the consumer purchasing patterns, especially when consumers approach a product for the first time. In such an encounter, consumers anticipate the emotions they might experience as a result of their decision, as they cannot realistically evaluate product performances. The work investigates the nature and the influence of these future-oriented emotions, namely anticipated and anticipatory happiness, in the first encounter with new products. Through a first laboratory study, adopting both physiological (micro-facial expressions analysis) and self-reported measures, we confirm the distinction between anticipated and anticipatory happiness. We further show the differential impact of these two emotional constructs on the consumer decision-making process by grounding on the Theory of Planned Behavior (TPB). Through a second study, based on a questionnaire, we further investigate the role of anticipated happiness within the TPB. We show that anticipated happiness is a pervasive emotional construct that influences all stages of the intention formation process. We discuss how these findings enrich existing knowledge on the interplay between cognitive and affective components of the decision-making process for new products. Moreover, we offer a methodological contribution to the use of physiological methods to assess emotions.

Development and validation of an instrument designed to measure factors influencing physician prescribing decisions

Background:

Previous attempts to develop an instrument to measure factors that influence prescribing decisions among physicians were relatively insufficient and lacked validation scale.

Objective:

We present a new tool that attempts to address this shortcoming. Hence, this study aims to develop and validate a self-administrated instrument to explain factors that influence the prescribing decisions of physicians.

Methods:

The questionnaire was developed based on literature and then subjected to an exhaustive assessment by a board of professionals and a pilot examination before being administered to 705 physicians. Three pre-tests were carried out to evaluate the quality of the survey items. In pre-test 1, after items are generated and the validity of their content is assessed by academics and physicians. In pre-test 2, the scale is carried out with a small sample of 20 respondents of physicians. In pre-test 3, fifty drop-off questionnaires were piloted amongst physicians to test the reliability.

Results:

On the basis of partial least squares structural equation modelling (PLS-SEM) analyses using SmartPLS 3, the content and convergent validity of the instrument were confirmed with 44 items grouped into four categories, namely, marketing efforts, patient characteristics, pharmacist variables, and contextual factors with 13 reflective constructs.

Conclusions:

The study outcomes prove that the scale is more valid and reliable for measuring factors that influence the decision of the physician to prescribe the drug. The development and presentation of a scale of thirteen factors related to physicians prescribing decisions help to ensure valid findings and facilitates comparisons of studies and research settings.

Exploring value-dense environment in the healthcare service delivery

Purpose

The purpose of this paper is to explore the antecedents and consequences of a value-dense environment in healthcare service delivery.

Design/methodology/approach

A structural model was developed based on a literature review. Circulation of a 31-indicator questionnaire among service receivers in the healthcare system across India generated 279 valid responses. The research model was assessed using a cross-sectional research design, and the data were analyzed by partial least squares-structural equation modeling.

Findings

Integrated supply chain performance (ISCP), internal service quality (ISQ) and coordinated care are antecedents of a value-dense environment, which drives patient-centricity. The leagile supply chain strategy strengthens the relationship between ISCP and coordinated care. Employee trust and commitment acts as a moderator between coordinated care and ISQ.

Research limitations/implications

By adopting the perspective of service receivers, this paper highlights the influence of value-density on patient-centricity in healthcare organizations. Future research should include healthcare professionals’ perceptions of value-dense environment creation.

Practical implications

The study provides suggestions to practitioners for designing patient-centric healthcare services by leveraging ISCP, coordinated care and ISQ in the value-creation process. Recognizing the relationships among these constructs can aid the timely formulation of corrective actions and future policies.

Social implications

This study underscores patient-centric care as a basis for effectively delivering healthcare as a social good.

Originality/value

This paper contributes to the body of knowledge by identifying and empirically validating the relationships between patient-centricity and value co-creation.

Measuring and enhancing organisational creative climate, knowledge sharing, and innovative work behavior in startups development

Purpose

The purpose of this paper is to examine the role of the organizational creative climate, knowledge sharing and innovative work behavior in startups development. This study also aims to discover the R square, predictive relevance and effect size of the developed model.

Design/methodology/approach

A quantitative method was used, and a total of 352 usable questionnaires were collected from employees at startups particularly in services sector in Malaysia. The structural equation was developed to explain the complicated relationship between organizational creative climate, knowledge sharing and innovative work behavior. The results of hypothesis were analyzed using structural equation modeling – partial least square (SEM-PLS) test.

Findings

The results indicate that organizational creative climate significantly influence innovative work behavior (H1), organizational climate positively affects knowledge sharing (H2) and knowledge sharing significantly influence innovative work behavior (H3). In addition, the results also show that the R square values of innovative work behavior is weak (R2 = 0.067), while the predictive relevance value demonstrating the model has sufficient predictive relevance. Further, the results of effect size show medium effect for organizational creative climate and knowledge, while the remaining indicates small effect size.

Practical implications

This study provides a comprehensible and clear understanding on how organizational creative climate and knowledge sharing play important role in fostering the individual innovative work behavior in Malaysian startups.

Originality/value

Research on the significance of organizational creative climate, knowledge sharing and to innovative work behavior particularly in the startups context has not been sufficiently explored. This study shed new light to the startups eco-system stakeholders in stimulating individual innovative work behavior through the practices of sharing information as well as the creative climate and innovative elements in the entrepreneurial activities.

Organizational learning and patient safety: hospital pharmacy settings

Purpose

The purpose of this paper is to explore the relationship between organizational learning and patient safety culture in hospital pharmacy settings as determined by the learning organization survey short-form (LOS-27) and pharmacy survey on patient safety culture instruments, and to further explore how dimensions of organizational learning relate to dimensions of pharmacy patient safety culture.

Design/methodology/approach

This study is a cross-sectional study. Data were obtained from three public hospital pharmacies and three private hospital pharmacies in Kuwait. Partial least square structural equation modeling was used to analyze the data.

Findings

A total of 272 surveys (59.1 percent response rate) were completed and returned. The results indicated a significant positive relationship between organizational learning and patient safety culture in hospital pharmacy settings (path coefficient of 0.826, p-value <0.05 and R2 of 0.683). Several dimensions of the organizational learning showed significant links to the various dimensions of the pharmacy patient safety culture. Specifically, training (TRN), management that reinforces learning (MRL) and supportive learning environment (SLE) had the strongest effects on the pharmacy patient safety culture dimensions. Moreover, these effects indicated that MRL, SLE and TRN were associated with improvements in most dimensions of pharmacy patient safety culture.

Originality/value

To the best of the authors’ knowledge, this is the first attempt to assess the relationship between organizational learning, patient safety culture and their dimensions in hospital pharmacy settings.

Developing Sustainable Healthcare Systems in Developing Countries: Examining the Role of Barriers, Enablers and Drivers on Knowledge Management Adoption

Knowledge management (KM) adoption is crucial to integrating sustainable development within the healthcare sector. Different barriers, enablers, and drivers affect KM adoption. Identifying these barriers, enablers, and drivers and their role in KM adoption is the core of successful KM adoption. However, there is scarcity of studies applying quantitative models and combing barriers, enablers and drivers to check their effect on KM adoption, especially form a developing country’s perspective such as Pakistan. Therefore, this study explores the role of barriers, enablers and drivers on KM adoption in Pakistan. Healthcare professionals participated in the data collection process, and results were analyzed using structural equation modeling. The findings described that: (1) organizational and strategic barriers have significant negative association with KM adoption; (2) government related enablers have significant positive association with KM adoption; (3) healthcare related drivers, and performance-based drivers have significant positive association with KM adoption. This study concludes that government intervention to promote KM adoption is necessary especially in developing countries. These findings will be helpful for the healthcare professionals and policy makers to promote KM adoption in healthcare sector. Current study contributes to the healthcare literature and body of knowledge by providing the empirical evidence of checking the quantitative effect of barriers, enablers and drivers on KM adoption.

Comparing causal techniques for rainfall variability analysis using causality algorithms in Iran

Causal analysis (CA) is a strong quantitative approach whose mechanisms have climatic predictions. In this study, we studied the patterns of causality (PC) on the effect of rainfall (ER) using climatic series collected from 170 stations for the period 1975-2014 in Iran. Next, we predicted the causal relationships of climatic variables using causal models, including first-generation techniques (FGT), second-generation techniques (SGT), third-generation techniques (TGT), and causal hybrid techniques (CHT). Then, we estimated the causal models using partial squares algorithms (PSA), mechanical equations modeling algorithms (MEMA) such as exploratory and confirmatory methods, and spatial variability methods such as geostatistics and spatial statistical methods. Finally, we evaluated the quality of the methods using the goodness of fit indices, including absolute fit indices (AFI), comparative fit indices (CFI), and parsimonious fit indices (PFI). The results showed that CHT algorithm more suitably predicted the climatic spatiotemporal effect variability (SEV) by extracting direct, indirect, and total effects of climatic variables. Based on the CHT algorithm, the highest and lowest effect values were observed in total effects of winter rainfall (0.98) and summer rainfall variables (0.1), respectively. The SEV ranged from 0.8 to 0.98 for the winter rainfall total effects of CHT in Iran. Using CHT, most of the predicted SEV, particularly the rainfall series, displayed SEV varying from 80% to 98% of the winter rainfall total effects to the annual rainfall in Iran. Similarly, based on the CHT, the highest and lowest SEV values were in western, eastern, and southern regions and in central regions, respectively. In addition, the SEV varied within the range of 0.6-0.74 (varying from 60% to 74% for the autumn rainfall total effects of the annual rainfall in Iran) for the autumn rainfall total effects in Iran. Finally, the SEV of this type of analytical pattern as well as designated subject of CA applications in the atmospheric science and environmental science are discussed.

The relationship between training satisfaction, organisational citizenship behaviour, and turnover intention

Purpose

The purpose of this paper is to explore the role of training satisfaction as a predictor of organisational citizenship behaviour (OCB) and turnover intention. The study further examines the mediating role of OCB between training satisfaction and turnover intention.

Design/methodology/approach

Data were collected from 409 Malaysian oil and gas (O&G) sector employees. Partial least squares structural equation modelling (PLS-SEM) was used to test the hypotheses in the research model using SmartPLS 3.0.

Findings

This study highlights the significant positive impact of training satisfaction on OCB and the negative effect on turnover intention. Contrary to expectations, OCB proved to be neither a predictor of turnover intention nor a mediator in the model.

Practical implications

Although the main aim of this study was to test the theoretically driven hypotheses, the findings have a number of valuable implications for organisations. This study suggests that O&G organisations should focus on increasing employee satisfaction with training to maximise desired workplace attitudes and behaviours.

Originality/value

This is the first study to explore the causal links between training satisfaction, OCB and turnover intention. Although it has been observed in the past that training does not directly influence turnover intention, the present study indicates that training satisfaction significantly influences turnover intention. Further, this study unexpectedly found no direct relationship between OCB and turnover intention. Also, OCB was not a significant mediator in the present study. These unexpected findings open new avenues for future research, thus representing an important contribution of the present study.