The healthcare scenario in developed countries is changing deeply: patients, who are frequently affected by multi-pathological chronic conditions, have risen their expectations. Simultaneously, there exist dramatic financial pressures which require healthcare organizations to provide more and better services with equal (or decreasing) resources. In response to these challenges, hospitals are facing radical transformations by bridging, redesigning and engaging their organization and staff. This study has the ambitious aim to shed light and clearly label the trends of change hospitals are enhancing in developed economies, in order to fully understand the presence of common trends and which organizational models and features are inspiring the most innovative organizations. The purpose is to make stock of what is known in the field of hospital organization about how hospitals are changing, as well as of how such change may be implemented effectively through managerial tools. To do so the methodology adopted integrates a systematic literature review to a wider engaged research approach. Evidence suggests that the three main pillars of change of the system are given by the progressive patient care model, the patient-centered approach and the lean approach. However, there emerge a number of gaps in what is known about how to exploit drivers of change and their effects. This study confirms that efforts in literature are concentrated in analyzing circumscribed experiences in the implementation of new models and approaches, failing therefore to extend the analysis at the organizational and inter-organizational level in order to legitimately draw consequences to be generalized. There seem to be a number of “gaps” in what is known about how to exploit drivers of change and their effects, suggesting that the research approach privileged till now fails in providing a clear guidance to policy makers and to organizations’ management on how to concretely and effectively implement new organizational models.

The main objective of this paper is to introduce and illustrate relational event models, a new class of statistical models for the analysis of time‐stamped data with complex temporal and relational dependencies. We outline the main differences between recently proposed relational event models and more conventional network models based on the graph‐theoretic formalism typically adopted in empirical studies of social networks. Our main contribution involves the definition and implementation of a marked point process extension of currently available models. According to this approach, the sequence of events of interest is decomposed into two components: (a) event time and (b) event destination. This decomposition transforms the problem of selection of event destination in relational event models into a conditional multinomial logistic regression problem. The main advantages of this formulation are the possibility of controlling for the effect of event‐specific data and a significant reduction in the estimation time of currently available relational event models. We demonstrate the empirical value of the model in an analysis of interhospital patient transfers within a regional community of health care organizations. We conclude with a discussion of how the models we presented help to overcome some the limitations of statistical models for networks that are currently available. Copyright © 2017 John Wiley & Sons, Ltd.

Background: Previous research suggests that multidisciplinary team communication networks enhance knowledge exchange, learning, and quality of care in health organizations. However, little is known about team members’ reliance on face-to-face versus electronic-based communication networks for information and knowledge exchange. Purpose: The aim of the study was to describe patterns of face-to-face versus electronic-based communication networks in a multidisciplinary team and to explore the relationships between team communication networks and performance, measured as promptness of treatment implementation. Methodology: We collected data on work-based communication among members of a multidisciplinary tumor board (MDT) in a large Italian research hospital. A social network survey was administered in 2016 to all board members to gather network data on face-to-face interaction and the use of electronically based communication channels (e-mail, text messages, and WhatsApp) for sharing clinical knowledge. Twenty physicians (71%) completed the survey. Archival data were accessed to obtain detailed information about 222 clinical cases discussed over a 1-year period during weekly MDT meetings. Minutes of board meetings were used to link all discussed cases to team members. We used the multiple regression quadratic assignment procedure (MR-QAP) to study associations between team member characteristics and communication networks. Negative binomial regression was employed to test relationships between team communication networks and performance. Results: MDT members relied on different communication channels for knowledge sharing. The geographical proximity of team members positively predicted the frequency of face-to-face interaction. Physicians’ seniority was related to the use of WhatsApp as a communication channel; greater interaction of this type was observed between team members of different seniority. Performance was related positively to face-to-face communication networks but negatively to communication via WhatsApp. Practice Implications: Although team communication networks are important for knowledge exchange, health administrators must pay attention to the increasing propensity of team members to rely on electronic-based communication. The use of these easy-to-use tools can hinder the quality of group discussion and debate.

Psychological and social characteristics of individuals are important determinants of their health choices and behaviors. Social networks represent “pipes” through which information and opinions circulate and spread out in the social circle surrounding individuals, influencing their propensity toward important health care interventions. This paper aims to explore the relationship between students’ vaccination health choices and their social networks. We administered a questionnaire to students to collect data on individual students’ demographics, knowledge, and attitudes about vaccinations, as well as their social networks. Forty-nine pupils belonging to 4 classrooms in an Italian secondary school were enrolled in the study. We applied a logistic regression quadratic assignment procedure (LR-QAP) by regressing students’ positive responsive behavior similarity as a dependent variable. LRQAP findings indicate that students’ vaccination behavior similarity is significantly associated with after-school social ties and related social mechanisms, suggesting that pupils are more likely to share information and knowledge about health behaviors through social relationships maintained after school hours rather than through those established during the school day. Moreover, we found that vaccination behaviors are more similar for those students having the same ethnicity as well as for those belonging to the same class. Our findings may help policymakers in implementing effective vaccination strategies.

This article contributes to prior accounting and public management research on performance measurement systems’ (PMSs) effectiveness in professional organisations, exploring how medical professionals’ perception regarding goal importance, knowledge of performance information, and accessibility of performance information affect their achievement of individual‐level performance targets. The study draws on primary and secondary data from 128 Italian public healthcare professionals about their perceptions of performance information and their factual performance. The findings show that perceived goal importance is positively related to one's knowledge of individual and peer performance information; that this relation is positively moderated by perceived information accessibility, and that knowledge of individual (but not peer) performance information fully mediates the relation between perceived goal importance and achievement of individual‐level performance targets.