A number of healthcare experts acknowledged the importance of indicators on patient satisfaction and patient safety measures. Those indicators were almost in the highest rank of usage among the relevant articles mentioned in the last subsection. This seems to suggest that indicators on patient satisfaction and patient safety are universally acknowledged important for hospital management. Similar to the patient perspective, indicators on employee satisfaction and occupational safety, i.e., needle stick injury, were rated highly “useful” by a majority of the Japanese experts. This trend was also shared with the relevant studies performed in other countries. In addition, as can be seen in Table 3, healthcare respondents assigned high value of “usefulness” on many indicators from the management perspective, most of which also appeared in the former Western studies. In contrast, a Japanese-specific trend to work conditions was seen from the results of expert ratings: several indicators on this issue, specifically related to workload, i.e., overtime, length of service and the number of staff per bed, were acknowledged “useful” for hospitalmanagement.3.3. Indicator selection for Japanese context integrating results of the literature review and the questionnaire survey, as well as interviews with healthcare professionals, we tentatively selected a minimum set of key performance indicators (Table 4) for holistic hospital management in the Japanese context. These indicators were determined in the following procedure: we first selected indicators that frequently appeared in the relevant articles. Subsequently, we modified – removed “meaningless” indicators from and inserted additional “useful” indicators to –the first selection of indicators by taking into account the Japanese healthcare context from the results of the questionnaire survey and expert interviews. Finally, the revised set of indicators was confirmed by the project members from viewpoints of face, content and construct validities. Overall satisfaction has been typically assessed by a survey using a questionnaire which includes multiple items of healthcare elements. Thus, the questionnaire can be made to cover other satisfaction indicators such as satisfaction with treatment, physicians and nurses. Therefore, all related indicators from the patient and the employee perspectives were substituted to patient satisfaction survey and employee satisfaction survey, respectively. Neither frequently used nor rated “useful” culture/climate indicator was identified by the literature review or questionnaire survey. However, a safety culture survey was included to generate indicators from the management perspective due to the importance of safety culture for modern hospital management [25,26].