Quality Of Health Care Delivery Research Articles

Designing, implementing and evaluating childbirth training protocol for undergraduate midwifery students with a computer and mobile application based on gamification method: study protocol

BackgroundClinical education plays a very important role in creating the necessary abilities and skills in the students of medical sciences. Any problem in clinical education complicates the patient safety and quality of health care delivery. In this regard, "continuous evaluation", "educational innovation", and "participatory learning" will contribute to more efficiency, and all the mentioned items can be implemented in gamification. The present study is to design, implement, and evaluate a childbirth protocol training application based on gamification in midwifery students.MethodsThis educational scholarship study will focus on all midwifery students entering Babol University of Medical Sciences in 2020 and 2021 during the second semester of the 2023–2024 academic year. The educational intervention will cover six childbirth protocol topics presented through gamification to two groups of midwifery students. Students will complete a demographic and Sibria Sherring's emotional intelligence questionnaire before the intervention, the childbirth protocol knowledge questionnaire and performance checklist at the mother’s bedside before and four weeks after the intervention, and the training method satisfaction questionnaire four months’ post-intervention. Data will be analyzed using SPSS 28 software with a significance level of less than 5%.ResultsThis study will involve preparing, teaching, and evaluating six childbirth protocol topics through a game. It is assumed that the findings indicate that the educational method of gamification is better than the lecture method and by increasing the learning rate, the teaching process will be improved and the students will be fully satisfied with the teaching method.DiscussionThe effectiveness of the gamification method has been reported in various studies in the education of nurses, cardiopulmonary neurology for students, and health professions for medical students. Therefore, this approach can be effective in the delivery of protocol education for midwifery students. This study was approved by the Ethics Committee of Smart University of Medical Sciences (IR.SMUMS.REC.1402.029) and the study protocol was registered in the Iran Clinical Trial Registry (IRCT20180218038783N7).

Characteristics of patients leaving the emergency department without being seen by a doctor: The first report from Türkiye.

The presence of patients who leave without being seen (LWBS) by a physician in the emergency department (ED) is an essential indicator of the accessibility and quality of healthcare delivery. A high LWBS rate implies low patient satisfaction. This study aims to analyze the prevalence and characteristics of LWBS patients in Türkiye and their ED readmission rate within 3 days. This retrospective, single-center, observational study was conducted in the ED of a Turkish tertiary university hospital. It looked at patients who left without being evaluated by a physician admitted to the ED between June 01, 2021, and June 01, 2023. Data on age, gender, residential area, health insurance status, ED readmission within 3 days, complaints, and hospitalization were obtained through the hospital's electronic record system. The prevalence of LWBS patients was 0.43%. Only 0.6% (n = 5) of LWBS patients had no health insurance. About 12.8% (n = 99) of them were 65 years and older. About 10.2% (n = 79) of LWBS patients were readmitted to the ED within 72 hours. The most common reason for readmission was musculoskeletal system complaints. Statistically, ED readmission was significantly more common in older adults (P = .05). Older LWBS patients are more likely hospitalized upon return visits to the ED (P = .014). LWBS patients are both a result and a consequence of ED crowding. A zero LWBS rate is crucial for older adults' health as they may fall victim to an invisible accident while avoiding ED traffic. Prioritizing older adults and reorganizing waiting areas can reduce ED crowding and cost burden due to delayed treatments.

Considering patient-centred care and patient empowerment as essential to quality health care delivery in Ghana

Background: Rising cases of non-communicable diseases (NCDs), poor health choices, mistrust of the health system, self-medication, resistance of diseases to medication and dissatisfaction with the service experience serve as red flags on the path to Universal Health Coverage (UHC).Aim: This study explored the importance of patient-centred care (PCC) and patient empowerment (PE) within the context of healthcare service delivery in Ghana.Setting: The study considered PCC and PE from the perspective of three public healthcare facilities within the Greater Accra region.Methods: The researcher adopted a qualitative exploratory research approach. The study employed purposive sampling for the selection of healthcare facilities and healthcare providers. Convenience sampling was applied to select patient participants. A total of 33 in-depth interviews and 4 focus group discussions (FGDs) were conducted across the three sampled facilities as part of the data collection process.Results: Healthcare providers and patients unanimously view quality as essential for effective healthcare delivery. The application of the capacitating role of PE and PCC is inexact and largely left to subjective interpretation.Conclusion: The Ministry of Health (MOH) has recognised that patient experiences, a key indicator of care quality, have often been suboptimal and is actively working to address these weaknesses.Contribution: This study supports the call for health systems to remain committed to efforts to achieve UHC, with a focus on PCC and PE.

Development and validation of situational judgement test for assessment of behavioural competencies required for effective medical practice in Nigeria

BackgroundThe personal qualities of health workers determine the way health services are provided to clients. Some key personal qualities (also called behavioural competencies) of physicians that contribute to quality healthcare delivery include ethical responsibility, empathy, patient-centeredness, diligence, good judgment, respectful, teamwork, team leadership/conflict management, ability to take correction and tolerance. In this study, we developed and validated clinical scenarios (dilemmas) for assessing priority behavioural competencies for medical practice in Nigeria.MethodsDrawing on prioritized competencies generated via a scoping review and nominal group technique (NGT) exercises in a previous study in the study series, Faculty members from the University of Nigeria Teaching Hospital were consulted to develop or adapt clinical scenarios that could be used to assess these competencies in a physician. The clinical scenarios and options were framed as situational judgement tests (SJTs) and these tests were administered to a random sample of 192 undergraduate and 111 postgraduate medical doctors in a tertiary hospital in Enugu State. Using Kane’s validity argument framework, we assessed scoring and generalization inferences of situational judgment tests (SJT) based on the developed scenarios.ResultScoring inference – difficulty and discrimination index – shows that most of the SJT items are good test items and can differentiate between high and low performers. The corrected point biserial correlations show positive correlation for most of the items. Generalization inference shows the items represent the domains of interest and are internally consistent. However, few items that show poor difficulty and discrimination index were subjected to re-evaluation and possible elimination.ConclusionThis study has produced a set of valid clinical scenarios that can be used to evaluate specific behavioural competencies among trainee medical doctors. It demonstrates that SJTs can be used to assess behavioural competencies for medical practice. However, further research is needed to establish the applicability of SJT beyond the immediate context, such as the medical school, in which it is developed.

New colleague or gimmick hurdle? A user-centric scoping review of the barriers and facilitators of robots in hospitals.

Healthcare systems are confronted with a multitude of challenges, including the imperative to enhance accessibility, efficiency, cost-effectiveness, and the quality of healthcare delivery. These challenges are exacerbated by current healthcare personnel shortages, prospects of future shortfalls, insufficient recruitment efforts, increasing prevalence of chronic diseases, global viral concerns, and ageing populations. To address this escalating demand for healthcare services, healthcare systems are increasingly adopting robotic technology and artificial intelligence (AI), which promise to optimise costs, improve working conditions, and increase the quality of care. This article focuses on deepening our understanding of the barriers and facilitators associated with integrating robotic technologies in hospital environments. To this end, we conducted a scoping literature review to consolidate emerging themes pertaining to the experiences, viewpoints perspectives, and behaviours of hospital employees as professional users of robots in hospitals. Through screening 501 original research articles from Web-of-Science, we identified and reviewed in full-text 40 pertinent user-centric studies of the integration of robots into hospitals. Our review revealed and analysed 14 themes in-depth, of which we identified seven as barriers and seven as facilitators. Through a structuring of the barriers and facilitators, we reveal a notable misalignment between these barriers and facilitators: Finding that organisational aspects are at the core of most barriers, we suggest that future research should investigate the dynamics between hospital employees as professional users and the procedures and workflows of the hospitals as institutions, as well as the ambivalent role of anthropomorphisation of hospital robots, and emerging issues of privacy and confidentiality raised by increasingly communicative robots. Ultimately, this perspective on the integration of robots in hospitals transcends debates on the capabilities and limits of the robotic technology itself, shedding light on the complexity of integrating new technologies into hospital environments and contributing to an understanding of possible futures in healthcare innovation.

Patients' perspectives on key aspects influencing needling for haemodialysis: A qualitative study.

For many patients, cannulation ('needling') is essential for haemodialysis. It is associated with anxiety and fear and contributes to the overall burden of treatment. Limited research exists on patient experience of needling and how this might vary by individual and clinical characteristics. To explore and identify key aspects of needling impacting patients' experiences. Qualitative, multicentre, cross-sectional, co-produced. Adults on haemodialysis with working fistulae or grafts (n = 41). We used interviews to explore patients' experiences of needling and key aspects contributing to this. Interviews were conducted in two sets: unstructured (n = 24, broadly investigated needling experience) and semistructured (n = 17, refined themes and assessed cultural relevance). Thematic analysis was used to identify themes driving experience and examine variation. A Patient Steering Group comprising people with lived experience of needling was integral to the study. A thematic framework capturing patients' view of needling was developed. It defined a core theme (The Nature of needling) and five foundational aspects of needling (Health of the fistula or graft, Steps in needling, The needler, The patient, Organisational context). We identified two further themes important to overall experience, Learning from needling experience and Reciprocity (the two-way interaction between patient and needler). Both interrelated across themes, highlighting the complexity of needling and junctures where patient experience can be influenced. Needling is shaped by multiple psychological and relational influences. These findings provide healthcare professionals with a basis to improve patient experience as part of a broader drive to enhance quality in healthcare delivery.

Institutionalising guideline development in a new universal healthcare system: a study in Cyprus

Abstract Issue Guideline development is a lengthy and diligent process that involves the assessment and interpretation of evidence by a committee. Whilst the implementation of high quality healthcare guidelines ensures consistency and quality in healthcare delivery, many countries worldwide, including Cyprus, lack the capacity and resources to develop de novo guidelines. Description of the problem Guidelines developed by internationally recognised organisations, such as NICE, are a valuable resource for countries like Cyprus. The collaboration between NICE and the newly established healthcare system in Cyprus introduced a process for guideline institutionalisation, taking advantage of existing human resources and building guideline development capability in Cyprus. Results This process involved recruiting local professionals to form a guideline secretariat. The secretariat, supported by NICE, is responsible for overseeing the guideline development process including technical expert committee (TEC) recruitment and stakeholder consultation. The TEC contextualise an existing NICE guidelines to reflect local considerations. NICE provides quality assurance to ensure changes are contextual in nature and consistent with the underpinning evidence. Despite initial challenges, getting stakeholder buy-in and engaging healthcare professionals in the TEC, one contextualised guideline has been produced and two others are at the final stage. Lessons Guideline contextualisation is an efficient and sustainable way of building guideline development capability to institutionalize guidelines in settings with limited capacity. Key messages • De-novo guideline development is time consuming and demanding and many countries require an alternative process for producing locally relevant guidelines, capitalising on existing resources. • Support by an established organisation ensures quality, is less resource intensive, and builds capability for the sustainability of the process.

Analyzing the Maharashtra Ambulance Service “108”: The Prospect and Challenges

ABSTRACT The utilization of digital health in India is playing a crucial role in enhancing healthcare services by transitioning from the current inadequate public health structure to a more efficient and patient-centric system. Digital health includes various digital tools, such as electronic health records (EHRs), telemedicine, mobile health applications, health information exchange systems, and other technological advancements to improve access, efficiency, and quality of healthcare delivery. This study investigates the prospects and challenges encountered by the newly-digitized Maharashtra Emergency Medical Services (MEMS). Utilizing the 38,823 MEMS calls from November 2022, this study investigates the current status of emergency service delivery mechanisms in Maharashtra. Through spatial analyses, this study also explores the causes behind calls. The findings of the study show that calls for 108 ambulance services were distributed across the districts and had variable service delivery time periods. Current challenges to the system arise from various urban and healthcare infrastructure problems, as well as socio-cultural challenges. Implementation of the digitized MEMS system reveals key factors that influence the service’s success, assisting the policymakers and health administrators in identifying and further improving the service.

Empathy development through game-based learning: An investigative study on nursing professionals

BackgroundEmpathy is at the core of patient-centred care. Evidence has continually found that empathy helps foster therapeutic relationships and is essential in the delivery of quality healthcare. In India, many factors are barriers to empathy for nursing professionals. Objectives1.To design and test a game for Indian nurses to practice empathy.2.To develop and test reliability of a learner feedback form3.To test the impact of the game on the empathy of nurses Design and methodsThe IDEO design thinking process was followed to design the game. A focus group discussion with 18 nurses helped identify relevant scenarios and barriers to empathy. A scenario of an interaction between a nurse and a cancer patient was identified to create the game. The game mechanics, rubrics, and scenarios were built based on feedback from diverse professionals consisting of doctors, nurses, and UX designers. A learner feedback form assessing usability, contextual specificity, engagement, and perceived learnability was created and its reliability was tested. The game was tested on 60 nurses, followed by administration of the learner feedback form. To assess changes in empathy, an empathy scale was administered before the intervention and seven days after the intervention on 20 nurses. ResultsThe learner feedback form was found to have Cronbach's Alpha >0.70, and therefore reliable. The responses to the learner feedback form were analysed using the Chi Square test and were found to be positive and statistically significant (p-value<0.001).The differences in pretest and posttest empathy scores were analysed using the Wilcoxon Signed Ranks test and were found to be statistically significant as well (p-value<0.001). ConclusionsThe positive response to the learner feedback form, and the improvement in empathy scores after the intervention, indicates that games have a potential role in teaching empathy to Nursing Professionals.

Perceived structural empowerment, resilience, and intent to stay among midwives and registered nurses in Saudi Arabia: a convergent parallel mixed methods study

BackgroundRetaining midwives and registered nurses in the Obstetrics and Gynecology department/unit (OB/GYN) is not just a matter of organizational effectiveness and financial wellness. It’s a crucial aspect of ensuring quality healthcare delivery. This study aimed to discuss the degree to which midwives and nurses in OB/GYN departments are structurally empowered, resilient, and committed to remaining at the organizations and to examine whether nurses’ and midwives’sense of structural empowerment and resilience is a good predictor of their decision to stay with the organization.MethodsThis study employed a unique convergent parallel mixed methods approach. The research was conducted in two distinct phases. The first phase involved a cross-sectional quantitative survey with a convenience sample of 200 midwives and nurses in OB/GYN departments. The second phase was a qualitative study utilizing semi-structured, open-ended interviews. Eighteen nurses and midwives, specifically chosen as the target population, were invited to participate in individual interviews. The data collection took place at three major hospitals in Saudi Arabia, starting in January 2023 and concluding in February 2023.ResultsThe study results revealed that structural empowerment and resilience were statistically significant predictors of the intent to stay in the organization (F = 35.216, p < 0.001), with 26.3% variation, the structural empowerment is higher predictor (β = 0.486, p < 0.000) to intent to stay if compared to resilience (β = 0.215, p < 0.008). Five major themes emerged from the narratives of the nurses and midwives: the nurturing of the physical and physiological, the development of the psychological, the managing finances, the restructuring of the organization, and the enrichment of the professional and occupational.ConclusionThe study’s findings have significant implications for healthcare organizations. They highlight the importance of cultivating a culture of empowerment and resilience, which can serve as a powerful tool to encourage registered nurses and midwives to remain in their organizations. This insight empowers healthcare administrators, human resource managers, and obstetrics and gynecology professionals to take proactive steps toward improving retention rates.

The Role of Object Relations in the Physician-Patient Relationship in a Primary Care Setting.

A good physician-patient relationship is essential for the delivery of quality health care and is associated with better health outcomes. This study explored the association between patients' object relations and the physician-patient relationship. Primary care patients (n = 72) and physicians (n = 21) participated in the study. Patients' early memories were obtained prior to their medical visit and were coded with the Social Cognition and Object Relations-Global Method (SCORS-G). Patients and physicians independently rated the quality of the physician-patient encounter. Results indicated that object relations (SCORS-G Cognitive-structural and Self factors) incrementally predicted physician-patient relationship ratings, as rated by the patient, above and beyond psychological distress, somatization, and level of physician training. Patient education, psychological distress, and level of physician training predicted physician ratings of the medical encounter. The authors discuss the discrepancy between physician and patient ratings as they relate to patients' object relations.

Prevalence of actionable pharmacogenetic variants and high-risk drug prescriptions: A Swiss hospital-based cohort study.

Drug type and dosing recommendation have been designed and optimized based on average response in the general population. Yet, there is significant inter-individual variability in drug response, which results in treatment inefficacy or adverse drug reactions in a subset of patients. This is partly due to genetic factors that typically affect drug metabolism or clearance. To verify the relevance and applicability of international pharmacogenetic guidelines in the Swiss population, we genotyped 1533 patients from a hospital-based biobank who received at least 30 different drugs, as documented in their electronic health record. We then assessed the prevalence of clinically actionable variants in 13 high-risk pharmacogenes. We compared the allele frequencies obtained in the hospital-based cohort with those of a Swiss population-based cohort of 4791 individuals. The prevalence of clinically actionable variants was comparable between the two cohorts, with most study participants (97.3%) carrying at least one actionable pharmacogenetic variant. We then assessed the frequency of high-risk prescriptions due to actionable gene-drug interactions and observed that 31% of patients in the hospital-based cohort were prescribed at least one drug for which they carried a high-risk variant, and for which international guidelines recommend a change of drug or dosage. Our analysis confirms the high prevalence of actionable pharmacogenetic variants in the Swiss population. It also shows that a substantial minority of patients are exposed to drugs for which they carry potentially problematic variants. Implementing a genetically informed approach to drug prescribing could have a positive impact on the quality of healthcare delivery.

A Real-Time Dashboard Approach to Decision Support: An Exercise in Co-Design.

Laboratory tests play an integral role in the delivery of quality health care. However, evidence indicates variations in diagnostic testing, which can lead to patient safety risks. Electronic decision support systems are often identified as key to reducing diagnostic error. However, such tools are often introduced into a clinical setting with little understanding of clinician workflow and how tools are likely to impact this. This study reports a qualitative co-design methodology and results from the first phase in the design and development of an analytics-driven, dashboard approach to supporting clinician test ordering in the Emergency Department.

Experimentation of AI Models Towards the Prediction of Medium-Risk Emergency Department Cases Disposition Outcome.

The overwhelming volume of patients in emergency departments (EDs) is a significant problem that hinders the delivery of high quality healthcare. Despite their great value, triage protocols are challenging to put into practice. This paper examines the utility of prediction models as a tool for clinical decision support, with a focus on medium-severity patients as defined by the ESI algorithm. 689 cases of medium-risk patients were gathered from the AHEPA hospital, evaluated, and their data fed three classifiers: XGBoost (XGB), Random Forest (RF) and Logistic Regression (LR), with the prediction goal being the outcome of their visit, i.e. admission or discharge. Essential features for the prediction task were determined using feature importance and distribution analysis. Despite having many missing values or high sparsity datasets, several symptoms and metrics are recommended as crucial for outcome prediction. When fed the patients' vital signs, XGB achieved an accuracy score of 91.30%. Several chief complaints were also proven beneficial. Prediction models can, in general, not only lessen the drawbacks of triage implementation, but also enhance its delivery.

Maintaining the Psychological Well-Being of Physicians in the Uncertain Work Environment: A Practitioners Perspective

COVID-19 significantly altered the healthcare ecosystem and forced us to stretch the capacity to ensure healthcare delivery services. Physicians were on the frontline and acted as an important cog in the wheel of healthcare delivery. This unprecedented situation forced them to adopt to a new norm amidst uncertainty, potentially impacting their mental well-being and overall health. The study aims to investigate the coping strategies for physicians to maintain their psychological well-being during uncertain events such as COVID-19. By employing Analytic Hierarchy Process (AHP), the research prioritizes coping strategies that can improve physicians’ psychological well-being. This study affirms that the physicians working in healthcare during pandemic preferred adaptive strategies over maladaptive strategies. Maintained exercise, yoga/meditation (or similar), and behavioral disengagement are the three most preferred coping strategies. The study will benefit physicians and the policy makers, to achieve their agenda of enhancing physicians’ psychological resilience during uncertain events, ultimately contributing to the continuity and quality of healthcare delivery.

African Accounts of Religious Conversations and Interventions in Mental Healthcare

The importance of healthcare has attracted conversations from healthcare professionals, as well as other groups like the United Nations, academic institutions, governments, the private sector, and religious organisations, all contributing to healthcare conversations because healthcare is foundational to human survival. However, there are questions on the quality and gaps of conversations and interventions regarding mental health among religious groups. This is because the quality of healthcare delivery may be rooted in the quality of conversations and interventions. This study explores the quality of mental healthcare (MHC) conversations and interventions in Traditional Religions, Christianity, and Islam in Africa. It interrogates past and recent conversations and interventions within the frameworks of spiritual care (SC) as a form of compassion science, interreligious collaborations, spiritual healings, and allopathic collaborations. Lastly, it places a searchlight on the loopholes of spiritual care in MHC and recommends closure where possible in the pursuit of improved healthcare and well-being in Africa.

Perceptions and attitudes of nurse practitioners toward artificial intelligence adoption in health care.

With the ever-increasing integration of artificial intelligence (AI) into health care, it becomes imperative to gain an in-depth understanding of how health care professionals, specifically nurse practitioners, perceive and approach this transformative technology. This study aimed to gain insights into nurse practitioners' perceptions and attitudes toward AI adoption in health care. This qualitative research employed a descriptive and phenomenological approach using in-depth interviews. Data were collected through a semi-structured questionnaire with 37 nurse practitioners selected through purposive sampling, specifically Maximum Variation Sampling and Expert Sampling techniques, to ensure diversity in characteristics. Trustworthiness of the research was maintained through member checking and peer debriefing. Thematic analysis was employed to uncover recurring themes and patterns in the data. The thematic analysis revealed nine main themes that encapsulated nurse practitioners' perceptions and attitudes toward AI adoption in health care. These included nurse practitioners' perceptions of AI implementation, attitudes toward AI adoption, patient-centered care and AI, quality of health care delivery and AI, ethical and regulatory aspects of AI, education and training needs, collaboration and interdisciplinary relationships, obstacles in integrating AI, and AI and health care policy. While this study found that nurse practitioners held a wide range of perspectives, with many viewings AI as a tool to enhance patient care. This research provides a valuable contribution to the evolving discourse surrounding AI adoption in health care. The findings underscore the necessity for comprehensive education and training in AI, accompanied by clear and robust ethical and regulatory guidelines to ensure the responsible integration of AI in health care practice. Furthermore, fostering collaboration and interdisciplinary relationships is pivotal for the successful incorporation of AI in health care. Policymakers should also address the challenges and opportunities that AI presents in the health care sector. This study enhances the ongoing conversation on AI adoption in health care by shedding light on the perspectives of nurses, thereby shaping future strategies for AI integration.

Vertical integration and market consolidation in healthcare: Policy drivers and impact on physicians and patient care

As healthcare markets have become increasingly consolidated, the vertical integration of physician practices with hospital networks has drawn additional scrutiny. While vertical integration within healthcare was once predicted to improve efficiency and quality of healthcare delivery, empirical study has uncovered mixed results. In a review of existing literature, vertical integration has yielded inconsistent effects on health quality metrics, with modest improvements at best, but has consistently driven up prices. This article reviews economic theory and the real-world effects of vertical mergers within healthcare and discusses policies driving this trend. Given the impacts of vertical integration on healthcare outcomes, cost, patient choice and physician wellbeing, physicians should advocate for regulations that preserve sufficient competition in healthcare markets and diversity of practice settings.

Unlocking the potential of digital twins: Transforming hospital practices for better care

Digital twins are virtual replicas of physical assets or processes and have emerged as a promising technology in various industries, including healthcare. This paper explores the application of digital twins in hospital operations and talks about their role in enhancing patient care and improving workflow efficiency. Through a comprehensive review of the literature and analysis of case studies, we examine how digital twins are revolutionizing traditional hospital practices and improving the delivery of healthcare services. The paper begins with an introduction to digital twins in healthcare, which provides an idea of the technology and its underlying principles. We then explore the many ways in which digital twins are being implemented across different areas of hospital operations, from patient monitoring in the Intensive Care Unit (ICU) to medication management in the pharmacy. Throughout this paper, we have included flowcharts that will help the reader better understand the idea we pitch. Furthermore, the paper discusses the challenges and considerations associated with adopting digital twins in hospital settings, including data privacy concerns, interoperability issues, and the need for better infrastructure. We also explore emerging trends and future directions in digital twin technology. We try to predict how this technology may continue to evolve and shape the future of patient care. In conclusion, this paper underscores the potential of digital twins to transform hospital practices and revolutionize the delivery of healthcare services. By using the power of digital twins, hospitals can improve operational efficiency, personalize patient care, and ultimately improve the overall quality of healthcare delivery.

Leadership style, change management and job performance of health information management practitioners in tertiary hospitals in South-East, Nigeria

PurposeManaging patients’ health information is one of the building blocks of the health system and the adoption of health information technologies like electronic health records (EHRs) is expected to reduce the various challenges in keeping and accessing quality health-care data that aid decision-making among medical practitioners. This study aims to investigate how leadership styles and change management affected the job performance of health information management practitioners on their adoption of EHRs in tertiary hospitals in Nigeria.Design/methodology/approachThe study used primary data collected using a Likert scale questionnaire from 117 health information management officers and health information technicians in selected tertiary hospitals in South-Eastern Nigeria. The data were analysed using bivariate correlation and multiple regression techniques of inferential statistics.FindingsThe analyses revealed that transformational leadership style, transactional leadership style and change management had significant positive influence on the job performance of health information management practitioners. However, laissez-faire leadership style did not show any significant positive influence. A further analysis showed that the combined effects of leadership styles and change management were also affirmed to significantly influence the adoption of EHRs for quality health-care delivery in Nigerian tertiary hospitals.Originality/valueThe study contributes to health information management and the need to understand how leadership styles and change management can influence the adoption of EHRs. However, there is no adequate research that examined the role of leadership style and change management in influencing the job performance of Nigerian HIM practitioners regarding their usage of EHRs in tertiary hospitals in Nigeria.