Purpose The purpose of this paper is to give a comprehensive and updated analysis of the available literature on hospital dashboards. Design/methodology/approach A search of the current literature was performed by searching electronic databases, including Google Scholar, EBSCO and Medline, as well as books. Findings In all, 48 manuscripts consisting of peer reviewed articles, conference proceedings, case reports and text books were included in this review. Practical implications Despite the numerous advantages of performance dashboards, several authors have mentioned a number of challenges. It was evident from the literature that any setting requires significant effort, especially to ensure the quality of data being collected. In fact, significant investment, both in terms of financial and human resources, is required to achieve an effective dashboard. Furthermore, most of the studies available in the literature were individual case reports or anecdotal accounts rather than empirical studies. Thus, further research is required to ascertain the effectiveness of performance dashboards. In view of these findings, each organisation should make its own decisions whether or not to adopt performance dashboards. Originality/value Most of the literature is fragmented as it reports the use of different types of dashboards, namely strategic, tactical and operational, as separate tools. This literature review contributes to knowledge as it brings together the different types of dashboards and the cascading effect of one dashboard onto another in order to achieve and retain organisational alignment with the overall strategic goals.

Purpose Tertiary hospitals have registered an incremental rise in expenditure mostly because of the increasing demands by ageing populations. Reducing the length of stay (LOS) of patients within tertiary hospitals is one of the strategies, which has been used in the last decades to ensure health care systems' sustainability. Furthermore, LOS is one of the key performance indicators, which is widely used to assess hospital efficiency. Hence, it is crucial that policy makers use evidence-based practices in health care to aim for optimal LOS. The purpose of this paper is to identify and summarize empirical research that brings together studies on the various variables that directly or indirectly impact on LOS within tertiary hospitals so as to develop a LOS causal systems model. Design/methodology/approach This scoping review was guided by the following research question: "What is affecting the LOS of patients within tertiary-level health care?" and by the guidelines specified by Arksey and O'Malley (2005), and by Armstrong et al. (2011). Relevant current literature was retrieved by searching various electronic databases. The PRISMA model provided the process guidelines to identify and select eligible studies. Findings An extensive literature search yielded a total of 30,350 references of which 46 were included in the final analysis. These articles yielded variables, which directly/indirectly are linked to LOS. These were then organized according to the Donabedian model - structure, processes and outcomes. The resultant LOS causal model reflects its complexity and confirms the consideration by scholars in the field that hospitals are complex adaptive systems, and that hospital managers must respond to LOS challenges holistically. Originality/value This paper illustrates a complex LOS causal model that emerged from the scoping review and may be of value for future research. It also highlighted the complexity of the construct under study.

Purpose The purpose of this paper is to analyse hospital dashboards' visibility of information at different management levels to improve quality and performance in an acute general hospital. Design/methodology/approach Data were generated via 21 semi-structured interviews across different management levels. Findings All management levels had greater visibility of information, could make informed decisions, and registered performance improvement. Specifically, waiting time improved, however since introduction of hospital dashboards was work-in-progress at time of study, managers could not record improvement in terms of cost reductions, clinical effectiveness, patient safety and patient satisfaction. Different managerial levels had different visibility with top management having the greatest. Research limitations/implications In single case studies, where only one context is used, the findings cannot be reproduced in different contexts; even though most of the results could be matched with the current literature. Practical implications The need to have balanced key performance indicators that take into account other facets of improvements, apart from time, has been emphasised. Furthermore, if middle and departmental managers have greater visibility, this would allow them to work towards a strategic fit between the departments that they manage with the rest of the hospital. Originality/value There is scant literature regarding performance dashboards' enhancement of visibility of information at different management levels. Furthermore, according to the authors' knowledge, no other paper has tried to identify and discuss the different levels of information, which should be visible from bedside to board namely to management, clinicians and public.

Purpose The purpose of this paper is to identify the extent to which immigrant nurses have integrated within the Maltese healthcare system. Design/methodology/approach This research consisted of a qualitative case study approach which was conducted within Malta’s four public entities in the secondary care sector. In this case study, data were collected through 34 semi-structured interviews with ten nursing managers, 12 Maltese nurses and 12 immigrant nurses. The data were analysed using content analysis. Data were collected between June 2015 and July 2015. Findings Four themes emerged from the data. These were: human resources management, language barrier, cultural differences and discrimination. The recruitment of nurses to Malta from other countries translated into several positive and favourable outcomes, such as the sharing of knowledge. However, a number of negative and unfavourable outcomes are also indicated in the data including language barrier and discrimination. Research limitations/implications This paper presents a discussion of the issues experienced within a healthcare system in relation to the mobility of nurses. Increasingly, the nursing workforce across the globe comprises of professionals from various nationality, origin, training, culture and professional ethos. The findings are presented in an effort to inform policy makers, management and administrative structures regarding the issues pertaining to the prevalent growing reality of mobility in nurse populations. Originality/value This research study provides a unique contribution to the literature regarding the phenomenon of nurse mobility because it embraces the integration of nurses as a two-way process. Since data was collected from immigrant nurses as well as from local nurses and nursing managers, this study hopes to offer a different point of view from previous studies which largely focused on the views of immigrant nurses only.

Purpose Hospital length of stay (LOS) is not only a function of patient- and disease-related factors, but is also determined by other health system-wide variables. Managers and clinicians strive to achieve the best possible trade-off between patients’ needs and efficient utilisation of hospital resources, while also embracing ethical decision making. The purpose of this paper is to explore the perceptions of the hospital’s major stakeholders as to what affects the duration of LOS of inpatients. Design/methodology/approach Using a data-triangulated case study approach, 50 semi-structured interviews were performed with management, doctors, nurses and patients. Additionally, the hospitals’ standard operating procedures, which are pertinent to the subject, were also included in the thematic analysis. Findings This study shows that LOS is a multi-dimensional construct, which results from a complex interplay of various inputs, processes and outcomes. Research limitations/implications The findings emerging from a single case study approach cannot be generalised across settings and contexts, albeit being in line with the current literature. Practical implications The study concludes that a robust hospital strategy, which addresses deficient organisational processes that may unnecessarily prolong LOS, is needed. Moreover, the hospital’s strategy must be sustained by providing good primary care facilities within the community set-up, as well as by providing more long-term care and rehabilitation beds to support the hospital turnover. Originality/value The subject of LOS in hospitals has so far been tackled in a fragmented manner. This paper provides a comprehensive and triangulated account of the complexities surrounding the duration in which patients are kept in hospital by key stakeholders, most of whom were hands-on in the day-to-day running of the hospital under study.