Health Facility Managers Research Articles

Definitions, perspectives, and reasons for conscientious objection among healthcare workers, facility managers, and staff in South Africa: a qualitative study

Conscientious objection (CO) on the part of healthcare providers is a growing threat to safe abortion access. In South Africa, evidence suggests that this legal clause may be manipulated as a justification for public-sector healthcare providers to exempt themselves from their duties to provide essential reproductive health services as required by national laws and protocols. This qualitative study improves our understanding of the definitions, perspectives, and use of CO among providers, staff, and facility managers in South Africa, and CO’s effect on public-sector abortion availability. Using 18 focus group discussions and 23 in-depth interviews, we examined CO attitudes and behaviours of staff from health facilities that provide abortion care in Gauteng, Limpopo, KwaZulu-Natal, and Eastern Cape Provinces. We find that CO is invoked for a variety of reasons, some unrelated to the legal basis for objection. There have been progressive shifts in attitudes towards abortion over time, but stigma against women and girls who seek abortion remains substantial among staff at facilities providing abortion. Providers who offer abortion services also report high levels of discrimination and isolation from colleagues. Such factors, combined with operational barriers to offering quality abortion care (such as lack of training support or financial incentives) and lack of clarity on CO definitions and procedures, may incentivise some providers to invoke CO inappropriately. Dissemination of national guidelines on CO should be prioritised to reduce ambiguity, and interventions addressing abortion stigma should be considered for all facility staff to safeguard abortion availability in South Africa.

Impacts of COVID-19 on reproductive health service provision, access, and utilization in Ethiopia: Results from a qualitative study with service users, providers, and stakeholders.

Ethiopia has made significant improvements to sexual and reproductive health (SRH) in recent decades, yet the COVID-19 pandemic brought new challenges to SRH service delivery. In the early months of the pandemic, health facility and health management information system data showed reductions in SRH service utilization, however more evidence is needed on ongoing SRH impacts to inform policy and program decision-making. Our study aimed to assess the impacts of COVID-19 on SRH service utilization and access from the perspective of providers, clients, and stakeholders in Addis Ababa and Amhara Regional State. We collected data from May through July 2021 via six focus group discussions with health service providers, 50 in-depth interviews with SRH service clients and 15 key informant interviews with policy and programmatic stakeholders. All audio recordings were transcribed and translated from Amharic into English. Data were coded and analyzed for content and themes using Excel and NVivo 10. We found that COVID-19 and associated public health mitigation measures had consequences on SRH prioritization, funding, and service delivery. Efforts to halt the spread of COVID-19, such as gathering and transportation restrictions, also reduced access to SRH services. Fear of infection, costly and inaccessible transportation, commodity stockouts, and limited service availability all impeded access to and use of SRH services. For some women, this meant losing timely access to contraception and subsequently facing unwanted pregnancies. Providers experienced increased workloads, anxiety, and stigma as possible sources of infection. Our findings offer useful learnings for program and policy stakeholders aiming to meet SRH needs during the pandemic, and during times of crisis more broadly.

Availability of Infection Control Protocol and Facilities, Practice Level and Barrier Perception Among Healthcare Workers in Secondary Healthcare Facilities, Southern Cross River State, Nigeria

The practice of infection prevention and control is key to prevention of healthcare acquired infections and protection of healthcare workers, patients and public health. There are however several challenges militating against the use of standard precautions among healthcare workers. This study was aimed at assessing availability of infection prevention and control (IPC) protocol and facilities, practice level and barrier perception among healthcare workers in secondary healthcare facilities, Southern Cross River State, Nigeria. The study adopted a cross-sectional descriptive design using quantitative methods to elicit information from 336 healthcare workers. A structured questionnaire was administered to respondents in this study an observational checklist was also used. The data generated was analyzed using SPSS version 25. The study comprised of 87.5% females and 12.5% males. Existence of IPC protocols in the facilities was assessed and over half of the respondents (53%) agreed to the availability of IPC protocols in their healthcare facilities. The study identified lack of: knowledge, time, equipment/materials and resources as factors perceived by healthcare workers as influencing their practice of IPC. Among all the factors, only lack of equipment/materials was found to be a significant perceived barrier to practice of IPC (t= 0.269, 0.012). The level of IPC practice was however found to be higher among those who perceived these factors as barriers. It is concluded that lack of time, knowledge, materials/equipment and resources are probable factors influencing practice of infection prevention and control in the secondary healthcare facilities. Healthcare facility management should make adequate provision of requirements for infection control in addition to training of staff and regular monitoring of compliance among health workers to protect public health.

Texting for life: a mobile phone application to connect pregnant women with emergency transport and obstetric care in rural Nigeria

BackgroundDifficulty in transportation to access skilled providers has been cited repeatedly as a major barrier to utilization of emergency obstetric care in Nigeria.ObjectiveThe objective of this paper is to describe the design, implementation, and outcomes of a mobile phone technology aimed at rapidly reaching rural Nigerian women who experience pregnancy complications with emergency transportation and access to providers.MethodThe project was implemented in 20 communities in two predominantly rural Local Government Areas (LGAs) of Edo State, in southern Nigeria, as part of a larger implementation project aimed at improving the access of rural women to skilled pregnancy care. The digital health innovation named Text4Life, allowed women to send a brief message from their mobile phone to a server linked to Primary Health Care (PHC) facilities and to access pre-registered transport owners. Pregnant women were registered and taught to text short messages to a server from their mobile phones or those of a friend or relative when they experience complications.ResultsOver 18 months, 56 women out of 1620 registered women (3.5%) texted the server requesting emergency transportation. Of this number, 51 were successfully transported to the PHC facilities, 46 were successfully treated at the PHC, and five were referred to higher-level care facilities. No maternal deaths occurred during the period, while four perinatal deaths were recorded.ConclusionWe conclude that a rapid short message sent from a mobile phone to a central server and connected to transport providers and health facility managers is effective in increasing the access of pregnant women to skilled emergency obstetric services in rural Nigeria.

Digital Twin–Based Health Care Facilities Management

Health care ensures the health and safety of people, and as such requires effective management of facilities. Unfortunately, current approaches to health care facilities management (HFM) are based on an “if it breaks, we fix it” approach. There is still no effective real-time monitoring of health care facilities, causing a lack of effective preventive maintenance. We propose digital twin (DT), which can monitor equipment and systems in real time and enable bidirectional coordination, to address the shortcomings of current health care facilities management processes. DT is the virtual representation of a physical asset in all instances and in real time. This study aims to identify the shortcomings in HFM and propose a DT prototype to improve HFM. The study adopts a mixed methodology including a literature review, a case study integrating interviews, and scenario planning. The study identified basic DT concepts and data dynamics. The study identified the adopted DT components including virtual design/modeling technologies, sensors, data analytics techniques, communication networks, and mobile devices, including the components integration and data flow management of the DT platform. Functional implementations for scenario deployment were also developed. The functional implementations addressed the following scenarios: monitoring the performance of the HVAC system using pressure criteria, monitoring indoor air quality (IAQ), monitoring the performance of pulsed light for deactivating bacteria and viruses and radio frequency (RF), as they affect the performance of the magnetic resonance imaging (MRI) machine. This paper concludes by highlighting the benefits and limitations of DT application in health care facilities management.

Abstract P563: Exploring Facility and Patient-Level Determinants of Changes in Systolic Blood Pressure Among Patients With Hypertension: A Multicenter Study in Ghana

Background: Optimal blood pressure control is essential in averting complications and associated cardiovascular risks. Although a 5-mmHg reduction in systolic blood pressure (SBP) is associated with better health outcomes, individual-level and health facility dynamics might influence optimal blood pressure control. We explored individual and health facility-level factors of SBP changes among patients with hypertension in Ghana. Methods: We recruited 15 health facilities that provided hypertension care and from each facility, 15 patients who were currently receiving hypertension care during their clinic appointment. We explored patient-level (adherence to treatment, length of time with hypertension diagnosis, and sociodemographic factors) and health-facility level (accessibility of care, health facility management, bed capacity, provider training, and provider-patient ratio) predictors. We fitted two-level mixed-effect linear regression models to identify predictors of SBP changes. Results: We included 222 patients, 81% were female, and 48% had achieved blood pressure control of < 140/90 mmHg. At the patient level, secondary-level education was associated with a 7.5 mmHg (95% CI: -14.74, -0.28) greater reduction in SBP than a primary or lower level of education (Table). Patients treated at private facilities had on average 15.8 mmHg (95% CI: 4.97, 26.62) higher SBP than those in government health facilities. Patients who were receiving care at health facilities where a physician or physician assistant treated ≥ 280 patients/month had 28.4 mmHg (95% CI: 9.77, 46.97) higher SBP than those receiving care from a physician/physician assistant who cared for < 140 patients/month. Conclusion: Health system interventions to address individual barriers, the shortage of healthcare providers, and team-based care strategies are needed to address the burden of hypertension in Ghana.

Use of collaborative learning approach for increased cure rate among children aged 6–59 months with severe wasting in Karamoja, Uganda

BackgroundAt 10%, Karamoja region has the highest rate of child wasting in Uganda. The region has 126 outpatient therapeutic care (OTC) sites for managing children with severe acute malnutrition.Local problemCure...

Groupe Néphrologie verte de la SFNDT : premières réflexions

Preserving the environment is becoming a universal priority. Human activities must be redesigned to best adapt them to available resources and to reduce their deleterious impact on the planet. The Green Nephrology Group of the “Société française de néphrologie, dialyse et transplantation” (SFNDT) has started a reflection on these issues, in particular on dialysis, a vital treatment but with high carbon production, associated with high water consumption. The data available on these points are presented such as, among others, the collection of indicators and action plans, the recycling of waste from water treatment, the reduction of dialysate flow, the reuse and regeneration of spent dialysate as well as calculations of carbon emission by dialysis activity. Architectural experiences are reported as well as the regulatory constraints applying to manufacturers and organizations in the sector. Potential solutions require the mobilization of all stakeholders, ranging from patients to health authorities, including caregivers, pharmacists, technicians, nephrologists and facility managers. They will be formalized very soon in a guide being prepared by the SFNDT Green Nephrology Group.

Management of Health and Welfare Facilities and Nursing Staff Job Satisfaction. Case Study of the General Hospital of St. Dimitrios

Introduction: Job satisfaction is defined by the overall feeling, that employees feel, as well as their personal feelings regarding their salary, the opportunities for promotion, the extra rewards, their boss and colleagues, the nature of the work produced, the working conditions and the level of communication between the different parts in the organization. Purpose: To investigate the professional satisfaction of nurses, which will help to document the influence of hospital organization and management on their satisfaction and show ways of improving it. Material and method: A sample of 152 nurses of the General Hospital “Agios Dimitrios” was selected. The study was conducted using Paul Spector's JSS (Job Satisfaction Survey) questionnaire, which has been used widely and globally for several decades to measure job satisfaction. The SPSS statistical software was used for statistical analysis and processing of the results. Results: 200 questionnaires were distributed, 155 were correctly returned completed. Most participants consisted of married women, 45-54 years old, TEI graduates, as nurses, having 11-20 years of experience, working shifts, paid 1000-1500 €. Low overall job satisfaction was documented regarding salary, promotion, benefits, potential rewards and communication, on the other hand operating conditions factors, associates and nature of work is moderate and the supervisory factor high. The majority of nurses (82 persons, 53.9%) were dissatisfied and only 6 persons (3.9%) were satisfied and the remaining 64 (42.1%) were neutral / moderate, which contributed to the overall low satisfaction. Satisfaction was influenced by responsibility, salary, shifts and work experience. Conclusions: The results depict the multilevel nature of job satisfaction as it depends on many factors and may be influenced by many characteristics of the employees. Key words: JSS Questionnaire, job satisfaction, nursing management, health system.

РОЛЬ ШТУЧНОГО ІНТЕЛЕКТУ ПРИ СТРАТЕГІЧНОМУ ПЛАНУВАННІ ДІЯЛЬНОСТІ ЗАКЛАДІВ ОХОРОНИ ЗДОРОВ'Я

Artificial intelligence (AI) has the potential to revolutionize the healthcare industry, including strategic planning. A key aspect of strategic management is that businesses in the same environment can have different levels of success, depending on their strategic decisions. In healthcare, it is also important for managers to develop strategic thinking in their employees. This will help them use strategic principles, methods, and tools to improve their performance. AI can be used to teach employees the basics of strategic planning. However, there are challenges and limitations to using AI in this context. Modern transformations in the healthcare sector require the implementation of strategic planning in management, as an important prerequisite for the successful functioning of a healthcare facility. AI is a tool that can be used to generate profit, as it can improve the economic performance of economies. This research has demonstrated the potential of AI to improve efficiency, effectiveness, and quality of care. AI can be used to analyze large amounts of data, identify trends, and predict future needs. This can help healthcare organizations develop more effective strategies that provide quality care at an affordable price. The article aims to define the features and potential of strategic planning in the management of healthcare facilities in the modern world using artificial intelligence to improve efficiency. This article explores the potential of AI in strategic management of healthcare organizations. It is argued that AI is a valuable tool for strategic planning in healthcare management. The article defines the concepts of "artificial intelligence" and "strategic planning in healthcare." It analyzes the areas of strategic planning where the use of AI is feasible. It proposes ways to use AI in healthcare management. The analysis and logical generalization of the research made it possible to determine the further direction and problems of using AI. The practical value of the article lies in the fact that it introduces readers to the possibility of using AI in strategic management in healthcare.

Changes in the management of healthcare facilities in the time of Covid-19 pandemic on a selected example

Changes in the management of healthcare facilities in the time of Covid-19 pandemic on a selected example

Factors Influencing Utilization of Routine Health Information for Decision Making Among Health Workers: A Case Study of Health Facilities in Moyo District, Uganda

Health information is a powerful vehicle for enhancing community health and it highlights both the problems and opportunities that exist for development. In Uganda, there are cases where decisions have been made without using health information in primary health care units. The existing capacity inadequacy to efficiently utilize information to track service use patterns over time to determine the impacts of policy and service delivery improvements in Uganda is one of the key weaknesses. With the support of the Ministry of Health, the government of Uganda is implementing projects to build and enhance the nation's web-based national health information system (DHIS2), which collects data from all health systems and allows for making decisions based on evidence on the delivery of health services. The broad study objective was to establish the factors influencing the utilization of routine health information for decisions making among the health workers. The research design was based on an analytical cross-sectional design. The target population for this study was 260 health workers specifically targeting those involved in the use of routine utilization of health information. Purposive sampling was used to select the key informants and other respondents were selected using simple and stratified random sampling. The self-administered structured questionnaire and key informants' interviews were used to collect data from respondents. The analysis of the quantitative data was done using descriptive statistics consisting of tables, bar graphs, pie charts, frequency, percentages, mean and standard deviations. Logistic regression analysis was conducted for establishing the association amongst the variables. The study established that technical factors (χ2=801.069; p=0.001), organizational factors (χ2=895.224; p=0.000), and behavioural factors (χ2=994.559; p=0.000) had a significant influence on utilization of routine health information for decision making. Talk of significant predictors of utilization of routine health information for decision making, technical factors (p = 0.013) had the greatest influence on utilization of routine health information for decision making among health workers at health facilities followed by organizational factors (p = 0.049). The study recommends that management of health facilities in Moyo district to create organizational culture through increased demand for and use of routine health information for evidence-based decision making in all aspects. The study further established areas of the routine health information system that requires to be reinforced and backed up to ensure the use of routine data in health facility to make decisions.

WORKFORCE DIVERSITY AND EMPLOYEE WORK PERFORMANCE AMONG SELECTED HEALTH WORKERS: EVIDENCE FROM SUB-SAHARA AFRICA

As industries and organizations continue to progress in the universal sphere, the concept of workforce diversity comes into play. Workforce diversity has been demonstrated to be the basis of employee performance. This basis drives management to understand and welcome the model of workplace diversity, its significance, and its challenges. The study sought to examine workforce diversity and its effects on employee performance in a sector that is made up of health workers. Age, gender, ethnicity, and educational qualification of employees were the antecedent of diversity which was critical for the study. The investigation was done by distributing 320 questionnaires as 293 were valid and usable questionnaires for the data analysis. The study findings show that there is a significant impact on performance when a diverse workforce is working in an institution. It was recommended that the management of the various health facilities should create an atmosphere that accommodates people from diverse backgrounds in other to enhance their work performance which would go a long way to improving organizations’ performance.

Strategická analýza ako súčasť strategického riadenia zdravotníckeho zariadenia

Healthcare represents a sector where growing competition, increasing demand for healthcare services, growing patient demands and significant developments in medical science make management increasingly challenging and complex. However, the optimal management model does not yet exist. However, it seems indisputable that one of the ways is the creation of a strategy and an increase in the level of strategic management of individual health facilities. Only a well-crafted strategy and its implementation, which is the result of a set of key decisions of a strategic nature, can succeed in a demanding competitive environment.

A Factor Analysis Of Dental Service Satisfaction In India: A Practical Investigation

Background: The main goal of offering high-quality dental treatment is to meet the requirements and expectations of patients, create strong connections between doctors and patients, meet defined criteria, and offer a framework for continuous improvement. Making sure patients are happy has been healthcare facilities' top priority. Examining what factors impact Indian patients' satisfaction with dental care is the aim of this study. Approach and methodology: Participants in this descriptive study were recent dental treatment recipients in the Delhi and National Capital Region areas, drawn from a variety of hospitals and independent clinics. A survey was utilised to gather the data. This survey received responses from 400 people in the Delhi/National Capital Region area. The regression method was employed for the data analysis. Result: Regression analysis showed that every single one of the investigated factors improved patients' overall satisfaction. A number of aspects of dental care service and its effect on consumer satisfaction were the primary foci of the research. The cleanliness of the dental clinic and the dentist's demeanour have the most impact on Indian patients' levels of satisfaction with their dental care. The link between patients' enjoyment and the dentist's conduct is substantial (r = 0.676), while the correlation between overall hygiene and patients' pleasure is moderate (r = 0.574). While there was a weak relationship between patient satisfaction and treatment cost (r = 0.111 for CO) and physical facility quality (r = 0.292 for PF), there was still some relationship. Conclusion: Results show that all of the theories were correct, however the overall strength of the relationship was slightly different, according to the empirical study's conclusion. The results can help healthcare facility and clinic managers prioritise these factors when planning programmes to boost patients' satisfaction. A strong doctor-patient relationship, improved hospital service quality according to patient opinions, and a system of continuous improvement can all be facilitated by the study's several dimensions of quality service.

Thematic, methodological, and editorial trends of preventive and community medicine theses in Tunisia over forty years

IntroductionThe assessment of the medical doctoral dissertation is a preliminary step in the promoting of scientific writing. this study aimed to describe the research topics, study designs and quality writing of Preventive and Community Medicine academic dissertations in Tunisia. Material and MethodsIt’s a bibliometric study covering the Preventive and Community Medicine doctoral dissertations performed in the faculties of medicine of Tunisia over forty years (1980-2019). The research topics were determined from the descriptors, grouped into major descriptors and thematic groups. The types of studies were classified according to the Evidence-Based Medicine pyramid. The editorial quality assessment was based on a 20-item grid, deduced from the International Committee of Editors of Medical Journals repository, and applied to the abstracts of thesis. It was considered satisfactory if the score was ≥75/100 points. ResultsIn total 595 PCM doctoral dissertations were performed in 40 years. Themes of dissertations were studied through 2580 index lines and 1030 descriptors. Healthcare-associated infections, maternal health, smoking, and high blood pressure accounted for 25.4% among major descriptors. The major research category evolved from "family medicine and primary care" (40.9%) before 2000 to management of health facilities” (26.7%) after 2000. The study designs were population studies or synthesis research, respectively in 259 (43.5%) and 22 (3.7%) doctoral dissertations. The quality of scientific writing was satisfactory in 34.6% of doctoral dissertations globally. ConclusionPreventive and Community Medicine doctoral dissertations suffered from methodological and editorial shortcomings, which required their reform based on bibliometric assessment, capacity building and structural reform.

Functionality of Primary Health Facilities Management Teams: Learning from 2017/2018’s Tanzania Star Rating Assessment

Background: Having a proper health system management with skilled health managers has been shown to be an important foundation for a high-quality health system. Primary Health Care (PHC) is important in ensuring the achievement of universal health coverage. To achieve this objective, it is important to strengthen the management of PHC facilities. This study aims at ascertaining the functionality of Health Facility Management Teams (HFMTs) in PHC facilities in the context of Star Rating Assessment (SRA) in Tanzania. Methods: This is a quantitative secondary data analysis using the SRA re-assessment data collected in the fiscal year 2017/18. HFMTs functionality was measured by the desirable performance of four indicators, namely availability of the HFMTs, formal appointment of HFMTs, regular meeting of HMT and quarterly meetings conducted. The proportions were compared by using proportion Z and chi-square tests. Results: This study involved 5933 PHC facilities, the majority of which were dispensaries (87.6%), rural located (78.3%) and public owned (77.2%). On average, 23.3% of HFMTs were functional. Among health facilities located in urban areas, 27.7% (95% C.I = 25.3% - 30.2%) had functional HFMTs which is significantly higher than rural located with 22.1% (95% C.I = 20.9% - 23.3%) (P -owned PHC facilities had 23.4% (95% C.I = 22.2% - 24.7%) of health facilities with functional HFMTs which is insignificantly different from 22.8% (95% C.I = 20.6% - 25.0%) of privately owned (P = 0.63). 47.5% of hospitals at the council level have functional HFMTs which is significantly higher compared to health centers (32.2%) and dispensaries (21.8%) (P Conclusions: Non-functionality of HFMTs is a challenge in PHC facilities in Tanzania. The challenge is more pronounced in rural located health facilities and lower-level PHC facilities (dispensaries). Measures including management and leadership training and mentorships are to be taken to enhance HFMTs functionality in these facilities.

Effects of computerized decision support on maternal and neonatal health-worker performance in the context of combined implementation with performance-based incentivisation in Upper East Region, Ghana: a qualitative study of professional perspectives

BackgroundComputerized decision support systems (CDSS) and performance-based incentives (PBIs) can improve health-worker performance. However, there is minimal evidence on the combined effects of these interventions or perceived effects among maternal and child healthcare providers in low-resource settings. We thus aimed to explore the perceptions of maternal and child healthcare providers of CDSS support in the context of a combined CDSS-PBI intervention on performance in twelve primary care facilities in Ghana’s Upper East Region.MethodsWe conducted a qualitative study drawing on semi-structured key informant interviews with 24 nurses and midwives, 12 health facility managers, and 6 district-level staff familiar with the intervention. We analysed data thematically using deductive and inductive coding in NVivo 10 software.ResultsInterviewees suggested the combined CDSS-PBI intervention improved their performance, through enhancing knowledge of maternal health issues, facilitating diagnoses and prescribing, prompting actions for complications, and improving management. Some interviewees reported improved morbidity and mortality. However, challenges described in patient care included CDSS software inflexibility (e.g. requiring administration of only one intermittent preventive malaria treatment to pregnant women), faulty electronic partograph leading to unnecessary referrals, increased workload for nurses and midwives who still had to complete facility forms, and power fluctuations affecting software.ConclusionCombining CDSS and PBI interventions has potential to improve maternal and child healthcare provision in low-income settings. However, user perspectives and context must be considered, along with allowance for revisions, when designing and implementing CDSS and PBIs interventions.

Interventions targeting healthcare providers to optimise use of caesarean section: a qualitative comparative analysis to identify important intervention features

BackgroundRapid increases in caesarean section (CS) rates have been observed globally; however, CS rates exceeding 15% at a population-level have limited benefits for women and babies. Many interventions targeting healthcare providers have been developed to optimise use of CS, typically aiming to improve and monitor clinical decision-making. However, interventions are often complex, and effectiveness is varied. Understanding intervention and implementation features that likely lead to optimised CS use is important to optimise benefits. The aim of this study was to identify important components that lead to successful interventions to optimise CS, focusing on interventions targeting healthcare providers. MethodsWe used Qualitative Comparative Analysis (QCA) to identify if certain combination of important intervention features (e.g. type of intervention, contextual characteristics, and how the intervention was delivered) are associated with a successful intervention as reflected in a reduction of CS. We included 21 intervention studies targeting healthcare providers to reduce CS, comprising of 34 papers reporting on these interventions. To develop potential theories driving intervention success, we used existing published qualitative evidence syntheses on healthcare providers’ perspectives and experiences of interventions targeted at them to reduce CS.ResultsWe identified five important components that trigger successful interventions targeting healthcare providers: 1) training to improve providers’ knowledge and skills, 2) active dissemination of CS indications, 3) actionable recommendations, 4) multidisciplinary collaboration, and 5) providers’ willingness to change. Importantly, when one or more of these components are absent, dictated nature of intervention, where providers are enforced to adhere to the intervention, is needed to prompt successful interventions. Unsuccessful interventions were characterised by the absence of these components.ConclusionWe identified five important intervention components and combinations of intervention components which can lead to successful interventions targeting healthcare providers to optimise CS use. Health facility managers, researchers, and policy-makers aiming to improve providers’ clinical decision making and reduce CS may consider including the identified components to optimise benefits.

Information Security Behavior in Health Information Systems: A Review of Research Trends and Antecedent Factors.

This study aims to review the literature on antecedent factors of information security related to the protection of health information systems (HISs) in the healthcare organization. We classify those factors into organizational and individual aspects. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. Academic articles were sourced from five online databases (Scopus, PubMed, IEEE, ScienceDirect, and SAGE) using keywords related to information security, behavior, and healthcare facilities. The search yielded 35 studies, in which the three most frequent individual factors were self-efficacy, perceived severity, and attitudes, while the three most frequent organizational factors were management support, cues to action, and organizational culture. Individual factors for patients and medical students are still understudied, as are the organizational factors of academic healthcare facilities. More individual factors have been found to significantly influence security behavior. Previous studies have been dominated by the security compliance behavior of clinical and non-clinical hospital staff. These research gaps highlight the theoretical implications of this study. This study provides insight for managers of healthcare facilities and governments to consider individual factors in establishing information security policies and programs for improving security behavior.