The critical impact of effective leaders listening in healthcare organisations is fundamentally about gathering and gaining operational intelligence from within the organisation. This core operational capability correlates with improved care and effectiveness across patient safety and clinical risk; quality and patient/resident outcomes; workforce sustainability; improvement innovation; and organisational resilience. Listening within organisations has become a hallmark of organisational capability, enabling leaders and managers to acquire operational intelligence. Comprehensive listening extends beyond providing staff and followers opportunities to speak, as it requires a comprehensive organisational capability (irrespective of, but proportional to, the size of the organisation). Annual surveys, suggestion schemes, and speak-up mechanisms provide valuable channels to hear feedback and enhanced listening approaches demonstrate a progressive and effective connection to those who make up and enable health organisations.
Objective: This study critically assessed the quality assurance procedures for Time- and Temperature-Sensitive Pharmaceutical Products (TTSPPs) in selected institutions of Sri Lanka. Design: A descriptive cross-sectional design was employed, involving direct observation and the use of a validated 99-item tool based on the guidelines of the World Health Organisation. Five domains and 18 subdomains were analysed, and scores were compared across institutional levels. Setting: Medical Supplies Division (MSD) of the Ministry of Health, Regional Medical Supplies Divisions (RMSDs), and selected tertiary and secondary hospitals in the North-Western Province of Sri Lanka Main Outcome Measures: The study covered five domains: general storage, indicators for temperature-controlled storage, transport, stock management, and general procedures/record-keeping. Results: General storage performed best across institutions (mean score 77.6%), with the MSD showing the highest adherence. However, temperature-controlled storage practices were inconsistent, particularly in hospital wards, due to inadequate monitoring, insufficient equipment, and limited preventive maintenance. The transport of TTSPPs showed the poorest performance (31.1%), with minimal temperature monitoring and calibration procedures in place. Stock management practices were stronger at higher-level institutions, largely due to the support of the Medical Supplies Management Information System (MSMIS). Conclusions: Overall, performance declined progressively from central to peripheral levels. Strengthening infrastructure, providing targeted in-service training, and instituting routine supervision using the assessment tool are recommended to enhance the reliability and sustainability of TTSPPs' quality assurance in Sri Lanka.
Objective: To examine the mediating role of the Child Health and Integrated Policy System (CHIPS) in linking cross-sectoral collaboration and cross-program integration with pediatric pulpitis incidence in Kendari City, Indonesia. Design: A cross-sectional quantitative study using Partial Least Squares Structural Equation Modeling (PLS-SEM). Setting: Fifteen public primary healthcare centers (puskesmas) in Kendari City, Southeast Sulawesi Province, Indonesia. Main outcome measures: Pediatric pulpitis incidence among children aged 6–12 years, obtained from facility-level administrative health records from 2022 to 2024. Results: Cross-sectoral collaboration was positively associated with CHIPS functionality (β = 0.634, p < 0.001), while cross-program integration also showed a significant positive association with CHIPS functionality (β = 0.306, p = 0.001). CHIPS functionality was negatively associated with the incidence of pediatric pulpitis (β = –0.667, p < 0.001). Mediation analysis showed that CHIPS fully mediated the relationship between cross-sectoral collaboration and pediatric pulpitis incidence (indirect β = –0.422, p < 0.001) and partially mediated the relationship between cross-program integration and pediatric pulpitis incidence (indirect β = –0.204, p = 0.004). Conclusions: CHIPS may serve as an important integrated governance mechanism linking collaborative policy implementation to reduced pediatric pulpitis incidence. Strengthening intersectoral coordination, program integration, and facility-level data systems may improve the effectiveness of pediatric oral health prevention within municipal primary healthcare systems.
Background: Disability poses significant challenges for individuals, families, and societies, leading to diminished quality of life. Hypertension is notably linked to disability among older adults. This study aimed to estimate the prevalence of disability and future healthcare costs among community-dwelling older adults with hypertension in Thailand from 2022 to 2040. Method: Data were obtained from the Health, Aging, and Retirement in Thailand (HART) survey, official government data, and published papers. The regression model was used to estimate the prevalence of disability among older adults. The micro-costing method was used to obtain the actual hospital service costs incurred for hypertensive patients. Then, the service costs of older adults with hypertension and the consumer price index were used to project future healthcare expenses. Results: Thailand’s population of older adults aged 60 years or older is projected to increase from 15.77 million in 2022 to 24.04 million in 2040. Approximately 46% of those had hypertension. The prevalence of disability among community-dwelling older adults with hypertension in Thailand ranged from 22-33%, and the incidence ranged from 11-18% by age group. There are an estimated 1.13 million older adults with hypertension and disability in 2022, and this number is forecasted to increase to 1.91 million by 2040. Disability-related healthcare expenditures among community-dwelling older adults with hypertension in Thailand are estimated to be USD 70.72 million in 2022 and are forecasted to reach USD 152.80 million by 2040. Conclusions: This study sheds light on the anticipated health burden faced by community-dwelling older adults with hypertension and disability, along with the associated healthcare costs in Thailand. These findings provide valuable insights for policymakers in formulating service provision strategies and budgetary planning at the national level.
Objective: This study explores hypertension management within Indonesian Posyandu Lansia (Elderly Integrated Health Posts). It aims to identify treatment practices, medication adherence, implementation barriers, and pharmacists’ roles to inform health service management and policy development for aged care. Design: An observational qualitative study was carried out using a phenomenological approach. The data were gathered through semi-structured interviews with a total of 32 participants, including 14 elderly patients, 12 community cadres, and 6 healthcare professionals. The collected narrative data were analyzed using an inductive thematic analysis to identify essential patterns and phenomena. Setting: The research was carried out at the Banguntapan II and Piyungan Puskesmas (Community Health Centers) and their affiliated Posyandu Lansia in Bantul Regency, Indonesia. Main outcome measures: Qualitative themes were identified regarding the implementation of hypertension treatment, medication adherence patterns, operational management barriers (e.g., funding and administration), and the integration of pharmacists into community-based settings. Result: Posyandu activities primarily focus on routine monitoring and social engagement, yet medication adherence remains low as many elderly patients only take medication when symptomatic. Critical management barriers include restricted village funding and heavy administrative burdens. Regarding the pharmacist's role, their involvement is primarily promotive and preventive, focusing on drug information education, counseling, medication safety monitoring, and stock control. However, these roles are not yet optimized because health center management prioritizes in-facility pharmaceutical services over community outreach. Conclusion: Effective hypertension management in community settings is hindered by operational and policy-related constraints. Pharmacists play an essential role in bridging education gaps and ensuring medication safety, yet their direct involvement remains limited. The practical implications of these findings suggest that strengthening interprofessional collaboration and revising policies to support direct pharmacist participation are vital for optimizing public health programs and improving clinical outcomes for the elderly population.
