Hospitals, Volume 2, Issue 1 (March 2025) – 4 articles

The implementation of evidence-based practice (EBP) is crucial for improving patient outcomes and healthcare delivery, yet it faces significant challenges in acute care settings due to organisational barriers, resource limitations, and leadership complexities. This study explores how ward managers (WMs) facilitate knowledge utilisation (KU) and promote EBP adoption in these environments. A longitudinal qualitative case study was conducted over eight months in two acute care hospitals in the East Midlands, England. Data were collected through semi-structured interviews with 23 WMs, nonparticipant observations, and document analysis. Thematic analysis was used to identify key findings. Six themes emerged: navigating leadership challenges, overcoming organisational and resource barriers, sustaining EBP through learning networks, integrating technology, tailoring EBP to patient-centred care, and providing emotional support for staff. Hybrid leadership strategies, combining directive and collaborative approaches, were critical in addressing barriers, fostering engagement, and embedding EBP into workflows. Mentorship and resource management also played pivotal roles. The study highlights the need for tailored leadership strategies, innovative resource utilisation, and sustainable learning networks to overcome systemic challenges and promote EBP. These findings provide actionable insights for fostering evidence-informed care environments in resource-constrained acute care settings. Full article

Slips and fall-related accidents cause a significant number of injuries in hospitals. Due to constant movement of doctors and nurses across different departments in hospitals such as OPD, trauma centres, and ICUs, there are possible interactions of their footwear with slippery floorings (e.g., wet or with soap suds), which may cause unexpected slips. To date, there is a lack of understanding on the traction of different footwear worn by hospital staff. This impedes the selection of appropriate floorings and footwear for preventing slips and falls in hospitals. In this work, the traction performances of twelve common footwear designs, worn by hospital staff, were tested on three different floorings at important locations, i.e., an outpatient department, trauma centre, and ICU entrance, at a busy public hospital. Oblique tread patterns are recommended for moderately rough floors under dry and Lizol conditions. Horizontally oriented patterns are better for smoother floors in dry conditions, while vertically oriented patterns are ideal for areas with frequent contaminant exposure. No specific recommendation can be made for soap-contaminated floors due to the contaminant’s high viscosity. The results also indicated the strong influence of flooring roughness on the measured traction, over footwear tread parameters. Also, liquid soaps were observed to significantly reduce footwear–floor traction. The findings are anticipated to be valuable to hospital management for the selection of appropriate high-traction floorings, and provide important guidelines for footwear selection, for the mitigation of slips and falls in hospitals. Full article

Hospital and health system bankruptcies and closures continue to rise in the United States. They are troubling news not only for patients and communities but also for insurance companies. Hospital closures often lead to higher costs for insurers due to increased claim denials, delayed payments, reduced provider network and access to care, higher out-of-network costs, and a disruption of our healthcare system. These factors ultimately impact the health insurance companies’ bottom lines as well as their ability to manage patient care effectively with the risk of causing customer/patient dissatisfaction. Insurance companies can help prevent hospital closures, especially in rural areas, by implementing some of the following mechanisms: timely and adequate payments; improved patient-centric payment systems; and standby capacity payments to cover minimum fixed costs. Such early strategic investments have the potential to offset the higher costs for insurance companies associated with hospital closures and improve the sustainability of the U.S. healthcare system. Full article

The role of clinical trials cannot be ignored due to its contribution to innovative treatment, therapies, and drug development in promoting quality service delivery. We investigated and explored the management aspect of clinical trials and its impact on healthcare service delivery within the NHS. A qualitative methodology with an interpretivism approach was adopted to collect data from nine participants using a purposive sampling method in the management of clinical trials at the NHS. A semi-structured interview with open-ended questions and probing techniques conducted via Microsoft Teams was used as a data collection tool. The collected data were thematically analysed with the support of NVivo 14 software. The staffs’ perceptions were somewhat effective and highlights required improvement for better performance regarding clinical trial management at the NHS setting. The findings represent improved patient outcomes, increasing evidence-based decision making, and the development of innovative therapies and research infrastructure could be some positive impacts of the effective management of clinical trials. However, the findings show that improvement in stakeholder collaboration and communication is vital to combat the existing challenges such as regulatory hurdles and issues in participant recruitment, retention, and communication. The findings provide practical values and insight into the staff working in the management of clinical trial processes and the audiences relevant to this field. A comprehensive understanding of the proactive measures and factors that are essential for the improvement of clinical trial management has been interpreted. In the hospital’s settings, supervision and improvement of clinical trials are necessary to promote innovative therapies, research infrastructure, and quality patient care and service delivery. Full article