Digital care transformation, the proliferation of disruptive technologies and the changing hybrid workforce have forced the evolution of traditional information technology network boundaries of healthcare organizations. The new landscape has rendered legacy existing perimeter defined and based cybersecurity solutions inadequate to meet increasing regulatory and federal demands for highly secure access management. Emerging compliance requirements, coupled with the concerning increase in healthcare data breaches, ransomware attacks, and security incidents targeting the healthcare sector, have transformed our historic notion of trust into an organizational vulnerability. A “Zero Trust” approach to information security is driven by an imperative to “never trust, always verify,” and requires strict, rigorous and continuous identity verification to minimize trust zones and their associated risk of security breach. Healthcare delivery organizations need to appreciate the importance of a Zero Trust strategy in reducing vulnerabilities, strengthening health system information security, and preventing successful security breaches, while also recognizing how identity and access management serves as the foundation of achieving Zero Trust.

Background: Understanding nurses’ perceptions about their nurse managers is a crucial element to consider as it helps in the performance of the nurse managers and retention of nurses and reflects the nature of a competent workforce in achieving the organisational goals.
Objective: To explore if there is a difference in perceptions of leadership style between nurse managers and their staff and discuss why this occurs.
Methods: A cross-sectional descriptive comparative research design was used.
Results: Nurse managers rated themselves as using transformational and transactional factors more than the nurses perceived them utilising these various leadership styles. Nurse managers, however, rated themselves lower than nurses in both laissez-faire and management-by-exception-passive.
Discussion: The leadership style preferred by the followers is consistently rated higher than the leadership style that their leaders are utilising. Formation of accurate self-perception is a delicate process, especially for people in management positions. Bias in higher self-ratings may occur for several reasons, including gender, which forms the basis of this discussion.
Conclusions: The results highlight the need for nurse managers to reflect on their practices and find new ways to enhance their leadership styles.

The quality and timeliness of public health data is a topic of prime concern in this information age. Many epidemiologists, health scientists and researchers in the public health domain have consistently emphasized on the importance of the need for the right timely data for the right decision-making at the right time. In other words, there is an urgent need to ensure that the right data reaches the right people at the right time. However, this urgent need appears to be misleading and not achievable in the current public health practices and workflow processes. The workflow processes in the current healthcare environments enable data collection to be delayed and only to be captured when the events have already occurred. In this paper, a systematic review of relevant scientific literature was used to not only explore the complexity and uniqueness of public health data, but also explain why improving the quality and timeliness of public health data is a challenging endeavor for many epidemiologists, health scientists and researchers. Recommendations for streamlining the public health workflow processes to support the generation of high-quality and timely public health data were also discussed in the paper.

Objective: The purpose of this study is to identify failures in proper Personal Protective Equipment (PPE) usage in a healthcare hospital environment to enhance PPE compliance through proper donning and doffing procedures.
Methods: We used naturalistic observation (shadowing) of PPE donning and doffing by healthcare medical staff in their hospital work setting to identify non-conformities to compliant donning and doffing of PPE.
Results: We found an average of 1.84 non-conformances per healthcare worker across the donning procedures and 2.06 non-conformances in the doffing procedures per healthcare provider. Nurses experienced 1.94 average non-conformances in the donning procedures, while physicians average 1.75 non-conformances. Nurses experienced 2.29 average doffing nonconformances, while physicians averaged 1.85 average doffing non-conformances during the study. PPE compliance is critical to protect both healthcare workers and patients in the healthcare setting, as well as building a culture of safety.
Research implications: Appropriate training and compliance should be performed to ensure appropriate PPE donning and doffing protocols are adhered to, so that it reduces the transmission of disease and infections. Future studies will explore the environmental, cultural and operational factors that contribute to PPE compliance in healthcare.
Conclusions: This is the first study to quantify donning and doffing errors of personal protective compliance within the realm of environmental and cultural impacts.

Objective: To describe the perceived importance among healthcare leaders of accurate patient identity in meeting organizational needs and objectives for improved clinical, operational and financial performance.
Methods: Survey of 100 US healthcare executives evaluated priorities and needs of care organizations as impacted by the imperative to ensure accurate patient identity in care delivery, operations, and meeting strategic objectives.
Results: Healthcare executives (72%) reported concern that inaccurate patient identity data reduces care quality/safety and healthcare organization financial performance. Only 14% were highly or extremely satisfied with the accuracy level of their existing patient identity management solutions. Inability to know “who is who” is perceived as increasing risk of patient harm and inferior care outcomes, low patient satisfaction, impeded operational efficiency and financial performance, and a key challenge to achieving strategic initiatives such as digital transformation and effective population health management. Accuracy in patient identity was linked to nearly all strategic priorities, with 60% considering it vital to every aspect of organizational performance, and 64% stating it can improve operational efficiency. Eighty-eight percent regarded accurate patient identity as essential to improving patient experience, care management (75%), and establishing an effective digital front door (73%). Majorities recognized the importance of accurate patient identity to organizational growth initiatives and digital transformation.
Conclusions: Although patient identity impacts most aspects of healthcare operations, leadership of most healthcare organizations surveyed understood the criticality of accurate patient identity in optimizing organizational performance, but lacked confidence in their ability to achieve a complete an accurate 360-degree view of patients.

Objective: Several variants of SARS-CoV-2 have emerged since its first appearance in 2019, greatly impacting healthcare systems across the globe. Previous literature indicated a substantial decline in emergency department (ED) visits in hospitals since the start of the COVID-19 pandemic. However, little research has been done to compare different variants’ (Ancestral, Alpha, Delta, Omicron, etc.) impact on patients presenting to the ED. Thus, the purpose of this retrospective observational study is to compare the changes in total ED volume following four major peaks of SARS-CoV-2 infection within a multi-hospital health system.
Methods: Utilizing electronic healthcare record (EHR) data, total ED visits (484,268) and COVID-19 case counts (24,358) were collected and analyzed to compare ED census and COVID-19 trends across four years and four variant peak periods, from January 2019 to June 2022.
Results: Results showed that ED visits declined after the first two major peaks (Ancestral and Alpha) in COVID-19 cases, which was consistent with national trends and prevailing literature. In contrast, ED visits increased following the fourth major peak (Omicron) in COVID-19 cases.
Conclusions: The increase in ED visits following the fourth major peak was inconsistent with previous literature and trends. This may be attributed to the severity differences between variants, increased vaccination uptake, newly adopted public countermeasures, and evolving perceptions of safety and fear regarding COVID-19. These results underscore the critical importance for health administrators and policy planners to be cognizant of new strategies that alleviate barriers to receiving emergency care, especially during times of crisis.