The role of kindness in healthcare is receiving increased attention. Indeed, international research shows that a culture of kindness has a positive impact on healthcare organizations, healthcare staff members, and patients. Benefits include better patient outcomes, as well as a humanized work environment, which helps to prevent stress and burnout among healthcare workers. Studies across different settings suggest that healthcare managers need to foster not only technical and organizational skills, but also social skills such as empathy and kindness. The purpose of this scoping review is to provide an overview of the current research landscape regarding initiatives based on acts of kindness in healthcare organizations. We will also explore whether this is a topic of interest to academics, which countries have conducted the most research on the subject, the practical implications for healthcare management, and potential directions for future research. This scoping review was conducted using the Arksey and O’Malley framework. A search was performed in the electronic databases ScienceDirect, Pubmed and Web of Science, to identify studies published in English between 1994 and 2023 describing or evaluating kindness-based interventions in the healthcare context. Based on the predefined eligibility criteria, screening and studies selection were performed. Data were extracted and analyzed descriptively to summarize the evidence. 19 studies were analyzed and included in the review. The article assessment revealed four categories: 1) organizational culture; 2) burnout reduction and staff well-being; 3) staff education / training; and 4) communication and patient experience. Kindness in healthcare is a relatively new topic, but of great scientific interest. The countries most interested in the topic are English speaking (with a particular interest in category 2) and Western European, and the methodology most commonly used to investigate this topic is qualitative. The need for additional research on kindness in healthcare arises from a complex and dynamic healthcare environment, where the concept of kindness holds the potential to revolutionize the quality of care and the well-being of healthcare providers. The interest of the various countries in the 4 thematic categories proposed by the study and the performance results of healthcare organizations promoting kindness compared to others without this focus also bear further consideration.

Healthcare overuse is a widespread issue, accounting for approximately 10–30% of total healthcare costs. This study examines the impact of a computer

Patient dissatisfaction frequently results in formal complaints, which can reveal critical issues related to care quality, communication, and organizational performance. The COVID-19 pandemic heightened public stress and may have contributed to an increase in complaints and staff burnout. Despite the importance of complaint analysis, long-term studies in this area - particularly in Switzerland - remain limited. This study examines how the pandemic influenced the volume and nature of formal complaints in a Swiss public hospital over a seven-year period. We conducted a retrospective observational study with an exploratory design in a Swiss public hospital with longstanding experience in complaint management. A single hospital was selected as a case study due to its leadership continuity, stable management structure, and mature quality assurance system. Semi-annually complaint incidence from 2017 to 2023 was analyzed using control charts and linear regression to identify temporal trends. The impact of the pandemic was assessed by comparing the pre-COVID (2017–2019) and post-COVID (2021–2023) periods. A statistically significant increase in complaints in the post-COVID period (p < 0.05, two-proportion Z-test) prompted further analysis by complaint category (clinical, managerial, relational). Finally, we assessed whether this rise could be linked to clinical quality by comparing the proportion of complaints that did not report actual but only potential clinical harm to patient health (classified by the hospital’s quality service as near-miss events) with those involving health-related concerns. The study used fully anonymized data, with no narrative or personal information and involved no patient interaction. Finally, we assessed whether this rise in complaints could be linked to clinical quality by comparing the proportion of cases referring to incidents with actual harm (classified as adverse) with those involving only potential harm (classified by the hospital’s quality service as near-miss events). The study used fully anonymized data, containing no narrative or personal information, and involved no patient interaction. A total of almost 800 complaints were recorded across 527,851 hospital admissions (1.5 per 1,000). Complaint incidence increased significantly over time (R² = 0.59, p = 0.0013), with peaks in S2 2022 and S1 2023. A statistically significant post-pandemic rise in complaint rates was observed (p < 0.05), particularly in relational complaints (+ 68%), followed by managerial (+ 59%) and clinical (+ 44%). While the overall number of complaints rose, the proportion of near-miss events was higher post-COVID, and no cases of severe harm were reported within the complaints received after 2020. This suggests a shift in the nature of dissatisfaction raised, with fewer complaints indicating actual patient harm. This study provides evidence of a marked increase in patient complaints - especially those related to relational aspects - after the COVID-19 pandemic. These findings highlight the need for targeted hospital strategies to improve communication, strengthen patient-provider relationships, and support staff. Investments in training and the systematic complaint monitoring can help identify early signs of dissatisfaction and guide quality improvement. Further research is needed to assess the long-term effects of these trends and the impact of relational care interventions on patient experience.

Healthcare systems face increasing pressure to reduce costs and improve care quality. Guideline adherence is essential for optimal patient outcomes, yet compliance remains inconsistent. Nudges - behavioral interventions modifying decision environments - have shown potential to enhance adherence, but their effectiveness varies by professional role and organizational factors. This study examines the impact of nudges on laboratory test prescriptions, assessing their effectiveness based on prescriber demographics, professional role, and hierarchical position. Additionally, it explores alert fatigue and prescriber perceptions of these interventions. A dataset of 929,808 laboratory test prescriptions issued between July 2021 and March 2024 across the Swiss EOC hospitals was analyzed. Prescription details, prescriber demographics, and alert outcomes were examined. Monthly adherence rates to alerts and appropriate prescription rates were assessed overall and by professional role. A cross-sectional survey (12-item Likert scale) evaluated prescriber perceptions. Statistical analyses included descriptive statistics, chi-square tests, time series analysis, and exploratory factor analysis (EFA) with varimax rotation. Group differences were analyzed using the Kruskal-Wallis test, Dunn’s procedure, and the Mann-Whitney U test. Of all prescriptions, 12.4% triggered alerts due to non-compliance with guideline-based Minimal Retesting Interval (MRI) criteria, internal standards collaboratively developed by EOC laboratory specialists and clinicians, aligned with international recommendations on laboratory test appropriateness. Among these, 11.9% of orders were canceled following the alert. Of these, 11.9% were canceled. Alert adherence varied by role, highest among heads of service (19.9%) and lowest among residents (9.6%). Compliance increased with age (p < 0.0001) and experience (p < 0.001) but declined over time (β = -0.08, p = 0.003), suggesting alert fatigue. Perceived usefulness of alerts was higher among nurses than physicians (p < 0.001). Despite greater adherence, senior physicians found alerts less useful. Professional hierarchy influences alert adherence, and sustaining behavioral change remains challenging. While electronic alerts can improve guideline compliance, alert fatigue limits long-term effectiveness. Optimizing alert design through personalization and context-aware triggers may enhance engagement. These findings provide insights for improving nudge-based interventions in clinical practice.