Stimulating the capacity to govern the commons.

The ability to strengthen governance institutions and fisheries restrictions and laws is needed to improve conservation and management of common-pool resources. We evaluated the potential for stimulating change with modest interventions by studying fishing village households before and after a 27-month intervention period in a high-priority coral reef conservation area. Interventions included training in catch monitoring, stock assessment, mapping fishing grounds, microcredit, gender inclusion, theatrical skills, fuel efficient stoves, and participation in the planning of a conservation proposal. There was a background increase in reported formal education, household size, group membership, and household wealth but a decrease in fish consumption and public services. Of conservation importance, the perceived strength of 13 governance institutions and benefits of 6 fisheries restrictions increased over the intervention period. Finally, correspondence between knowledge of and agreement with recent national fisheries laws was moderate to high and positively correlated. The intervention period was stronger than demographic factors that often influence perceptions, such as village, government services, gender, household size, membership in community groups, and age responses. In general, perceptions of strengths of governance and benefits of restrictions increased more among women and youth than adult men respondents. The largest changes in perceptions of increased benefits were among strict restrictions initially ranked low, specifically fisheries closures, parks, and species restrictions. Consequently, capacity building overrode demographic factors common to poor people with limited employment capacity that can have negative perceptions of strict conservation.

Variabilidad demográfica y escalas de aceptación y rechazo sobre las restricciones en el manejo de recursos Resumen Se necesita de la capacidad para fortalecer a las instituciones de gobierno y las leyes y restricciones a la pesca para mejorar la conservación y manejo de los recursos comunes. Evaluamos el potencial para estimular el cambio con intervenciones modestas con un estudio en los hogares de una aldea pesquera antes y después de un periodo de intervención de 27 meses en un área de conservación de gran prioridad para un arrecife de coral. Las intervenciones incluyeron formación en el monitoreo de las capturas, análisis de stock, mapeo de las zonas de pesca, microcréditos, inclusión de género, habilidades teatrales, estufas ecológicas y participación en la planeación de una propuesta de conservación. Hubo un incremento en el trasfondo de la educación formal reportada, el tamaño del hogar, los miembros del grupo y la riqueza del hogar, pero una disminución en el consumo de pescado y en el servicio público. Fue de importancia para la conservación que la fuerza percibida de 13 de las instituciones de gobierno y los beneficios de seis restricciones a la pesquería incrementaron durante el periodo de intervención. Por último, la correspondencia entre el conocimiento sobre y la aceptación de las leyes recientes de pesca fue de moderada a alta y con una correlación positiva. El periodo de intervención fue más fuerte que los factores demográficos que con frecuencia influyen sobre las percepciones, como las respuestas de los servicios de gobierno, aldea, género, tamaño del hogar, membresía en un grupo comunitario y edad. En general, la percepción de la fuerza de la gobernanza y los beneficios de las restricciones incrementó más entre las mujeres y la juventud que entre los hombres respondientes. Los cambios más grandes en la percepción del aumento en beneficios fueron entre las restricciones estrictas marcadas como bajas al inicio, específicamente el cierre de pesquerías, parques y restricción de especies. Como consecuencia, la formación de capacidad sobrepasó los factores demográficos, que con frecuencia son personas con una capacidad limitada de empleo que pueden tener una percepción negativa de la conservación estricta.

The Role of the European Reference Network for Rare Bone Diseases (ERN BOND) and European Registries for Rare Bone and Mineral Conditions (EuRR-Bone) in the Governance of the Management of Rare Bone and Mineral Diseases.

Rare diseases (RDs) bear a significant challenge to individuals, healthcare systems, and societies. The European reference network on Rare BONe diseases (ERN BOND) is committed to improving multidisciplinary, patient-centred care for individuals with rare bone and mineral diseases (RBMDs). Its affiliated project, the European registries for rare bone and mineral conditions (EuRR-Bone) collects data using two different platforms, an electronic surveillance system (e-REC) that captures the occurrence of RBMDs and the Core Registry, a platform with the infrastructure for collecting Core data fields and longitudinal generic and condition-specific information. With emerging registries and the overlap with other ERNs, it is key to maintain the capability of the platforms to adapt to the needs of the network and the community whilst adhering to quality and FAIR (findable, accessible, interoperable, and reusable) principles. This binomial ensures long-term sustainability and potential advances in the care pathway of RBMDs whilst promoting good practice standards within Europe and beyond.

Towards Evidence-Based Food Safety Governance with Wastewater-Based Epidemiology (WBE) Technology in China.

Pesticide residues in food pose significant risks to public health and have long been a major concern in Chinese cities. The management of these risks is influenced by various factors, including the characteristics of responsible officials. This study tests the relationship between the levels of pesticide residues and the responsible officials' interdisciplinary backgrounds and their tenure cycles, which is crucial for improving food safety governance in Chinese cities. Based on wastewater-based epidemiology (WBE) and data from 32 Chinese cities, it was found that the interdisciplinary backgrounds of officials had a significant negative relationship with urban pesticide residues in wastewater, indicating that the interdisciplinary knowledge background or working experience of officials in food safety-related agencies was associated with the supervision and control of urban pesticide residues. This study also generated evidence-based knowledge on how to improve food safety through assigning younger and interdisciplinary officials to the responsible governmental agencies, where WBE is more likely to be adopted.

Examining the impact of environmental centralization on enterprise total factor productivity through a quasi-natural experiment conducted in China.

This paper explores the effects and influence mechanisms of environmental centralization on enterprise technological progress and productivity in China. Taking the reform of vertical environmental governance (VEG) as a quasi-natural experiment, this paper compares the differences in total factor productivity (TFP) of enterprises in environmental centralization regions and environmental decentralization regions by adopting the staggered difference-in-differences (DID) method. The empirical results show that: (1) The average TFP of enterprises in the environmental centralization areas is 0.0598 higher than that in the environmental decentralization areas, and this average effect increases with the extension of the reform duration. (2) Environmental centralization strengthens government intervention in environmental issues. The improvement in the intensity of environmental regulation and the willingness of firm green innovation are the intermediate causes of the improvement in enterprise TFP. (3) VEG's effect is heterogeneous regarding regional development, industry type, and enterprise characteristics. This study has empirical implications for further refining the fiscal system to leverage the role of public finance on environmental governance and enterprise development.

Secondary Use of Health Data for Medical AI: A Cross-Regional Examination of Taiwan and the EU.

This paper conducts a comparative analysis of data governance mechanisms concerning the secondary use of health data in Taiwan and the European Union (EU). Both regions have adopted distinctive approaches and regulations for utilizing health data beyond primary care, encompassing areas such as medical research and healthcare system enhancement. Through an examination of these models, this study seeks to elucidate the strategies, frameworks, and legal structures employed by Taiwan and the EU to strike a delicate balance between the imperative of data-driven healthcare innovation and the safeguarding of individual privacy rights. This paper examines and compares several key aspects of the secondary use of health data in Taiwan and the EU. These aspects include data governance frameworks, legal and regulatory frameworks, data access and sharing mechanisms, and privacy and security considerations. This comparative exploration offers invaluable insights into the evolving global landscape of health data governance. It provides a deeper understanding of the strategies implemented by these regions to harness the potential of health data while upholding the ethical and legal considerations surrounding its secondary use. The findings aim to inform best practices for responsible and effective health data utilization, particularly in the context of medical AI applications.

Moving beyond Technical Issues to Stakeholder Involvement: Key Areas for Consideration in the Development of Human-Centred and Trusted AI in Healthcare.

Discussion around the increasing use of AI in healthcare tends to focus on the technical aspects of the technology rather than the socio-technical issues associated with implementation. In this paper, we argue for the development of a sustained societal dialogue between stakeholders around the use of AI in healthcare. We contend that a more human-centred approach to AI implementation in healthcare is needed which is inclusive of the views of a range of stakeholders. We identify four key areas to support stakeholder involvement that would enhance the development, implementation, and evaluation of AI in healthcare leading to greater levels of trust. These are as follows: (1) aligning AI development practices with social values, (2) appropriate and proportionate involvement of stakeholders, (3) understanding the importance of building trust in AI, (4) embedding stakeholder-driven governance to support these activities.

How the EU AI Act Seeks to Establish an Epistemic Environment of Trust.

With focus on the development and use of artificial intelligence (AI) systems in the digital health context, we consider the following questions: How does the European Union (EU) seek to facilitate the development and uptake of trustworthy AI systems through the AI Act? What does trustworthiness and trust mean in the AI Act, and how are they linked to some of the ongoing discussions of these terms in bioethics, law, and philosophy? What are the normative components of trustworthiness? And how do the requirements of the AI Act relate to these components? We first explain how the EU seeks to create an epistemic environment of trust through the AI Act to facilitate the development and uptake of trustworthy AI systems. The legislation establishes a governance regime that operates as a socio-epistemological infrastructure of trust which enables a performative framing of trust and trustworthiness. The degree of success that performative acts of trust and trustworthiness have achieved in realising the legislative goals may then be assessed in terms of statutorily defined proxies of trustworthiness. We show that to be trustworthy, these performative acts should be consistent with the ethical principles endorsed by the legislation; these principles are also manifested in at least four key features of the governance regime. However, specified proxies of trustworthiness are not expected to be adequate for applications of AI systems within a regulatory sandbox or in real-world testing. We explain why different proxies of trustworthiness for these applications may be regarded as 'special' trust domains and why the nature of trust should be understood as participatory.

Developing a Framework for Self-regulatory Governance in Healthcare AI Research: Insights from South Korea.

This paper elucidates and rationalizes the ethical governance system for healthcare AI research, as outlined in the 'Research Ethics Guidelines for AI Researchers in Healthcare' published by the South Korean government in August 2023. In developing the guidelines, a four-phase clinical trial process was expanded to six stages for healthcare AI research: preliminary ethics review (stage 1); creating datasets (stage 2); model development (stage 3); training, validation, and evaluation (stage 4); application (stage 5); and post-deployment monitoring (stage 6). Researchers identified similarities between clinical trials and healthcare AI research, particularly in research subjects, management and regulations, and application of research results. In the step-by-step articulation of ethical requirements, this similarity benefits from a reliable and flexible use of existing research ethics governance resources, research management, and regulatory functions. In contrast to clinical trials, this procedural approach to healthcare AI research governance effectively highlights the distinct characteristics of healthcare AI research in research and development process, evaluation of results, and modifiability of findings. The model exhibits limitations, primarily in its reliance on self-regulation and lack of clear delineation of responsibilities. While formulated through multidisciplinary deliberations, its application in the research field remains untested. To overcome the limitations, the researchers' ongoing efforts for educating AI researchers and public and the revision of the guidelines are expected to contribute to establish an ethical research governance framework for healthcare AI research in the South Korean context in the future.

Effect of the Cluster Nursing through Empowerment Education on Patients Undergoing Radical Prostatectomy: A Retrospective Study.

BACKGROUND: Radical prostatectomy (RP) is a treatment method for prostate cancer (PCa). However, patients usually experience urinary incontinence and a reduction in quality of life after surgery. Seeking a nursing programme is necessary to improve the prognosis of patients undergoing RP. This study aims to explore the effect of the cluster nursing through empowerment education on patients with RP. METHODS: The general data of 203 patients who underwent RP surgery from June 2021 to June 2023 were collected for a retrospective study. After excluding four patients who changed from RP to laparotomy during surgery, four patients with incomplete clinical data and three patients without normal communication ability, the remaining 192 patients were included in the study. The patients were divided into two groups in accordance with different nursing plans. In this study, 98 patients receiving the cluster nursing through empowerment education were set as the observation group (OG), and 94 patients undergoing routine nursing were included in the reference group (RG). The indicators of postoperative recovery, mental health status and life coping ability were compared between the two groups. RESULTS: The times to first exhaustion, to start eating, of first off-bed activity and of hospitalisation in the OG were shorter than those in the RG (p < 0.001). No significant difference was found in the total incidence of complications between the two groups (p > 0.05). Before management, no significant difference in the scores of Hospital Anxiety and Depression Scale (HADS) and Activity of Daily Living Scale (ADL) was observed between the OG and RG (p > 0.05). After management, the HADS and ADL scores of the two groups all decreased, and the OG showed a greater reduction in scores than the RG (p < 0.001). CONCLUSIONS: The cluster nursing through empowerment education can shorten the recovery time of patients after RP surgery and improve their living ability. This effect is beneficial to their mental health and can provide additional directions for the formulation of subsequent clinical nursing programmes.

[Contributions of urban planning for more food security in German cities]. / Beiträge kommunaler Planung für mehr Ernährungssicherheit in deutschen Städten.

Many German municipalities are developing retail concepts for retail management and taking stock of the food supply is one of the standard tools. A distance-based indicator is commonly used, which measures the degree of supply based on linear distances between the place of residence and the nearest place of purchase. Beyond this distance, however, access to food is influenced by other spatiophysical and socioeconomic factors. So far, these have hardly been considered. Inadequate access to food is not only problematic from a health perspective, but also because of the social function of food as an important field of social participation. Difficult access to food especially affects people in precarious circumstances, who are already restricted in their participation in society. This article therefore presents a model that theoretically informed, comprehensively and systematically captures the spatiophysical and socioeconomic embedding of food access. Based on selected results of a study that was carried out in Bremen using this approach, this article shows the access barriers that affect residents of two districts that are considered to be well supplied. The primary goal of this article is to raise awareness of the complex issue of food access. Finally, approaches that retail and other municipal initiatives can use to improve access to food are also named.

Dataset on the impact of implementing a shared governance model on the level of professional governance among nurses in Saudi Arabia: Insights from experimental data.

Shared governance is a concept that has been gaining popularity in the nursing field. It is a framework that allows nurses to have a greater role in clinical decision-making. This approach recognizes the expertise and knowledge that nurses possess and allows them to be active participants in the decision-making process. It is a way to empower nurses and to ensure that the best possible care is being provided to patients. By promoting shared governance, nurses are able to work collaboratively with other healthcare professionals and provide high-quality care that is evidence-based and patient-centered. This article presents data that was collected in an empirical study to investigate the impact of implementing a shared governance model on the perceptions of professional governance among nurses working in a tertiary hospital in Saudi Arabia by measuring the level of shared governance from the lowest level, the traditional governance level (management and administration only), to the highest level, the self-governance level (staff only), through six dimensions of nursing professional governance, including personnel, information, resources, participation, practice, and goals. The study was conducted over 8 months between July 2022 to February 2023 with the involvement of a random sample of 200 clinical nurses who completed a structured questionnaire before and after the study interventions as part of quasi-research. The interventions included designing and implementing a shared governance model, and providing a shared governance training to clinical to nurse participants. The pretest-posttest experimental group showed that there were improvements in the level of shared governance (shared governance level - primarily management/administration with some staff input), which denotes the effectiveness of nursing professionals governance training among nurses working in a tertiary hospital in Saudi Arabia. The data used in this study can be utilized by future studies for benchmarking purposes.

Improving health system responses when patients are harmed: a protocol for a multistage mixed-methods study.

INTRODUCTION: At least 10% of hospital admissions in high-income countries, including Australia, are associated with patient safety incidents, which contribute to patient harm ('adverse events'). When a patient is seriously harmed, an investigation or review is undertaken to reduce the risk of further incidents occurring. Despite 20 years of investigations into adverse events in healthcare, few evaluations provide evidence of their quality and effectiveness in reducing preventable harm.This study aims to develop consistent, informed and robust best practice guidance, at state and national levels, that will improve the response, learning and health system improvements arising from adverse events. METHODS AND ANALYSIS: The setting will be healthcare organisations in Australian public health systems in the states of New South Wales, Queensland, Victoria and the Australian Capital Territory. We will apply a multistage mixed-methods research design with evaluation and in-situ feasibility testing. This will include literature reviews (stage 1), an assessment of the quality of 300 adverse event investigation reports from participating hospitals (stage 2), and a policy/procedure document review from participating hospitals (stage 3) as well as focus groups and interviews on perspectives and experiences of investigations with healthcare staff and consumers (stage 4). After triangulating results from stages 1-4, we will then codesign tools and guidance for the conduct of investigations with staff and consumers (stage 5) and conduct feasibility testing on the guidance (stage 6). Participants will include healthcare safety systems policymakers and staff (n=120-255) who commission, undertake or review investigations and consumers (n=20-32) who have been impacted by adverse events. ETHICS AND DISSEMINATION: Ethics approval has been granted by the Northern Sydney Local Health District Human Research Ethics Committee (2023/ETH02007 and 2023/ETH02341).The research findings will be incorporated into best practice guidance, published in international and national journals and disseminated through conferences.

Governance of noncommunicable diseases in Afghanistan.

Background: Noncommunicable diseases (NCDs) are the main reasons of mortality worldwide. One of every two person is dying due to NCDs in Afghanistan. International policy actors, mainly the World Health Organization (WHO), published several reports and declarations on controlling and preventing NCDs. This study aimed to provide a situation for governance of NCDs in Afghanistan and proper solutions for identified challenges. Methods: We conducted qualitative research utilizing interpretive phenomenology. A self-developed questionnaire was developed to conduct the semi-structured interviews with 39 experts from Afghanistan. The results were analyzed using a deductive framework analysis. Six building block framework of health system developed by the WHO was used as predefined framework for this study. Results: The governance building block of health system consists of five subthemes including policy making, planning, organizing, stewardship, and control. We identified main strengths, weaknesses, opportunities, and challenges for these subthemes. The experts also provided key recommendations to address the challenges. Conclusions: Management of NCDs is a neglected part of the health system in Afghanistan. Strengthening evidence-based policy making with technical and indigenous planning, establishing responsive units with adequate financial and human resources within different ministries to address "health in all policies" concept, passing and implementing national laws and regulations to support national strategies for prevention and control of NCDs, and establishing decentralized monitoring systems to control the implementation of these strategies are the main recommendations of this study. Local government and international policy actors should invest and support the development of a multisectoral coordination system at national level for Afghanistan.

Negative effects of high public debt on health systems facing pandemic crisis: Lessons from COVID-19 in Europe to prepare for future emergencies.

The investigation goal here was to analyze how the level of public debt affects preparedness of health systems to face emergencies. In particular, this study examined the negative effects of high public debt on health systems of European countries in the presence of the COVID-19 pandemic crisis. Empirical evidence revealed that European countries with a lower level of government debt as a percentage of GDP both in 2009 and 2019 (the period before the arrival of the pandemic) had lower COVID-19 fatality rates compared to countries with higher levels of public debt. The explanation is that high levels of public debt in countries trigger budget constraints that limit their ability to allocate resources to healthcare systems (e.g., health expenditures and investments), weakening health system performance and causing systemic vulnerability and lower preparedness during emergencies, such as with the COVID-19 pandemic. Implications of health policies are suggested to improve strategies of crisis management.

Comparative analysis of environmental sustainability indicators: Insights from Japan, Bangladesh, and Thailand.

This study analyses environmental sustainability indicators (ESIs) and explores their governance challenges in developing countries (Bangladesh and Thailand) and advances possible remedies in light of the practices of a developed country (Japan). A comparative analysis of countries' performance based on the ESIs could help identify useful practices from countries with high ESI to improve the poor ESI countries. While it is broadly understood that renewable energy and effective governance support environmental sustainability, our findings extend this knowledge by detailing how these factors interact specifically within the contexts of developed and developing nations. The analysis delineates the complex relationship between GDP growth, fossil fuel reliance, and sustainability efforts, offering a detailed examination of the variance in ESI performance across these countries. Beyond established notions, this study empirically validates the relationships between environmental sustainability (ES) and its influencing factors, providing a country-specific analysis that emphasizes the differential impact of renewable energy adoption, governance quality, and economic policies on environmental sustainability in Japan, Bangladesh, and Thailand. The results also revealed that Bangladesh's performance in terms of majority ESIs ranges from bad to worse, while Japan exhibits good performance in all its ESI indicators except for emissions. Thailand's ESI performance indicates its vulnerability to climate disasters and slow growth of renewable energy. The ESI measures of Thailand have shown its susceptibility to climate-related calamities and a slowdown in the rate of renewable energy implementation. A noticeable discrepancy in the execution of regulatory frameworks was noted between developing countries, such as Bangladesh, and industrialized ones, such as Japan. The outstanding results of Japan's ESI may be credited to the successful practices of its citizens and their strong devotion to the rule of law.

The Role of Engineering Ethics in Mitigating Corruption in Infrastructure Systems Delivery.

Indications that corruption mitigation in infrastructure systems delivery can be effective are found in the literature. However, there is an untapped opportunity to further enhance the efficacy of existing corruption mitigation strategies by placing them explicitly within the larger context of engineering ethics, and relevant policy statements, guidelines, codes and manuals published by international organizations. An effective matching of these formal statements on ethics to infrastructure systems delivery facilitates the identification of potential corruption hotspots and thus help establish or strengthen institutional mechanisms that address corruption. This paper reviews professional codes of ethics, and relevant literature on corruption mitigation in the context of civil engineering infrastructure development, as a platform for building a structure that connects ethical tenets and the mitigation strategies. The paper assesses corruption mitigation strategies against the background of the fundamental canons of practice in civil engineering ethical codes. As such, the paper's assessment is grounded in the civil engineer's ethical responsibilities (to society, the profession, and peers) and principles (such as safety, health, welfare, respect, and honesty) that are common to professional codes of ethics in engineering practice. Addressing corruption in infrastructure development continues to be imperative for national economic and social development, and such exigency is underscored by the sheer scale of investments in infrastructure development in any country and the billions of dollars lost annually through corruption and fraud.

Effectiveness of public health spending: Investigating the moderating role of governance using partial least squares structural equation modelling (PLS-SEM).

BACKGROUND: The link between public health spending (PHS) and population health outcomes (PHO) has been extensively studied. However, in sub-Saharan Africa (SSA), the moderating effects of governance in this relationship are little known. Furthermore, studies have focused on mortality as the main health outcome. This study contributes to this literature by investigating the moderating role of governance in the relationship by simultaneously assessing three dimensions of governance (corruption control, government effectiveness and voice accountability) using disability-adjusted life years (DALYs) as a measure of outcomes. METHODS: The study applies the two-stage moderation approach using partial least squares structural equation modelling (PLS-SEM) to panel data from 43 SSA nations from 2013 to 2019. The study also uses domestic general government health expenditure (DGGHE) as an independent variable and disability-adjusted life years (DALY) as the dependent variable in this relationship. RESULTS: The analysis reveals that DGGHE affects DALY negatively and that governance improves the effect of DGGHE on DALY, with bigger improvements among countries with worse governance. CONCLUSION: These findings provide evidence that good governance is crucial to the effectiveness of PHS in SSA nations. Sub-Saharan Africa (SSA) countries should improve governance to improve population health.

Blockchain governance and trust: A multi-sector thematic systematic review and exploration of future research directions.

This paper aims to critically examine the scholarly work conducted in blockchain (BC) governance. Without venturing into the wide range of governance paradigms, this research considers governance structures based on trust as a foundation for BC governance. A thematic systematic literature review is conducted to understand the literature on this topic, employing the SALSA (Search, Appraisal, Synthesis and Analysis) technique. An examination of 155 papers shows that using BC technology (BCT) replaces the cognitive attribution of trust in the material and human-independent code. It is also found that further research anchored to the 'trust' concept is required in building BC governance structures. To provide the direction in which the literature is travelling, future research questions on trust and governance are documented. In general, the literature review suggests that BC has the potential to revolutionize the way in which businesses operate. By improving transparency, efficiency, and security, BC can help businesses to reduce costs, improve customer satisfaction, and make better decisions. This research can help policymakers, industrialists, and researchers to identify where BC governance is being used and which aspects of governance are to be focused on. This paper is a general review of literature and evidence on contemporary developmental issues.

The social effects of energy regulation: Energy-consuming rights trading system and corporate labor demand.

Although it is a key measure to control energy consumption and promote the improvement of industrial structure, energy market allocation reform has rarely been concerned with its impact on employment, an important livelihood issue. To fill this gap, this paper takes the Energy-Consumption Rights Trading System (ECRTS) enacted by China in 2016 as a research background and adopts the difference-in-difference approach to explore the effects and mechanisms of the ECRTS on enterprise labor demand. The results show that the ECRTS significantly reduces firms' labor demand, particularly for low-skilled workers, through both production scale effects and technological upgrading effects. Specifically, the ECRTS has led to a decrease in sales revenues and an increase in labor productivity, thereby reducing firms' labor demand. Heterogeneity tests indicate that the ECRTS has a greater impact on employment in firms with lower energy-consumption intensity, domestic capital injections, weaker innovation capacity, and lower market power. The paper also explores the welfare consequences of the policy, finding that while the ECRTS does not improve the environmental performance of firms it does not pass on the compliance costs of regulations to incumbent workers. The overall impact is neutral. This paper extends the study of the economic consequences of the ECRTS and has implications for other developing countries in reconciling energy regulation and employment.

Impact of C-level positions on hospital performance: a scoping review protocol.

INTRODUCTION: The objective of this scoping review is to identify evidence of the impact of hospital managers in top management (c-suite) on hospital performance. Managers generally have various effects on organisational objectives of their organisations. In recent years, the healthcare sector has experienced alterations in hospital governance structures, together with the emergence of new c-suite positions, aligning more closely with those found in private organisations. Their impact on hospital performance (ie, quality of care) is not well known. This scoping review seeks to identify all the available evidence of their impact on the organisational objectives. This scoping review will include primary studies, reviews and commentaries that describe the impact of top management team members on organisational outcomes in a hospital setting. METHODS AND ANALYSIS: The search strategy aims to locate both published and unpublished documents (ie, grey literature) using a three-step search strategy. An exploratory search of Medline and Google Scholar identified keywords and Medical Subject Headings terms. A second search of Medline (PubMed), Web of Science Core Collection, ScienceDirect, Business Source Premier (EBScoHost), JSTOR, BASE, Lens.org and the Google Search Engine will be performed. The scope of the search will cover 1990-present time using English search terms. Manual searching by two reviewers will be added to the search strategy. The identified documents will be independently screened, selected by two researchers and extracted by one researcher. The data are then presented in tables and graphics coupled with a descriptive summary. ETHICS AND DISSEMINATION: As this study neither involves human participants nor unpublished secondary data, an ethics approval is not required. Findings will be disseminated through professional networks, conference presentations and publication in a scientific journal. TRIAL REGISTRATION NUMBER: The protocol was registered on the Open Science Framework (https://doi.org/10.17605/OSF.IO/EBKUP).