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Surgical services are settings where resilient performance (RP) is necessary to cope with a wide range of variabilities. Although RP can benefit from a supportive built environment (BE), prior studies have focused on the operating room, giving scant attention to support areas. This study takes a broader perspective, aiming at developing BE design knowledge supportive of RP at the surgical service as a whole.

Seven BE design prescriptions developed in a previous work in the context of internal logistics of hospitals, and thus addressing interactions between workspaces, were used as a point of departure. The prescriptions were used as a data analysis framework in a case study of the surgical service of a medium-sized private hospital. The scope of the study included surgical and support areas, in addition to workflows involving patients and family members, staff, equipment, sterile instruments and materials, supplies, and waste. Data collection included document analysis, observations, interviews, and meetings with hospital staff.

Results identified 60 examples of using the prescriptions, 77% of which were related to areas other than the operating rooms. The developed design knowledge is framed as a set of prescriptions, examples, and their association to workflows and areas, indicating where it should be applied.

The design knowledge is new in surgical services and offers guidance to both BE and logistics designers.

This study aims to examine the perceptions and evaluations of Muslim COVID-19 survivors and health workers regarding the halal, business and ethical attributes of hospitals during their interactions related to COVID-19 treatment.

Descriptive qualitative research with semi-structured online interviews was used to gather insights from COVID-19 survivors and health workers who treated COVID-19 patients. The findings were then compared with existing literature on hospital services and Sharia attributes.

The study found that patients and health-care workers in hospitals are concerned about whether the hospital follows Sharia law, the quality of health-care and hospital services and the ethical conduct of hospital staff. This is especially true during the COVID-19 pandemic, when patients are more anxious about religious conduct and the afterlife.

Hospitals need to address halal attributes in all aspects of their services for Muslim patients and business attributes such as standard health-care quality, service quality and ethical attributes. Participants indicated that when these needs are met, they are more likely to revisit the hospital and recommend it to others.

This study contributes to understanding the expectations of Muslim patients regarding hospital services that meet Islamic ethical and business requirements. Using the COVID-19 pandemic as a case study broadens the understanding of how to better serve Muslim customers.

The outbreak of the COVID-19 pandemic has significantly impacted healthcare systems, presenting unforeseen challenges that necessitated the implementation of change management strategies to adapt to the new contextual conditions. This study aims to analyze organizational changes within the total hip replacement (THR) surgery pathway at multiple levels, including macro, meso and micro. It employs data triangulation from various sources to gauge the complexity of the change process and comprehend how multi-level decision-making influenced an unexpected shift.

A multicentric, single in-depth case study was conducted using a mixed-methods approach. Data sources included patient-reported outcome measures specific to the THR pathway and carefully structured in-depth interviews administered to managers and clinicians in two healthcare organizations serving the same population.

Decisions made at the macro level resulted in an overall reduction in surgical activities. Organizational changes at the meso level led to a complete cessation or partial reorganization of activities. Micro-level actions for change and adaptation revealed diverse and fragmented change management strategies.

Organizations with segmented structures may require a robust and structured department for coordinating change management responses to prevent the entire system from becoming stuck in the absorptive phase of change. However, it is important to recognize that absorptive solutions can serve as a starting point for genuine innovations in change management.

The utilization of data triangulation enables the authors to visualize how specific changes implemented in response to the pandemic have influenced the observed outcomes. From a managerial perspective, it provides insights into how future innovations could be introduced.

This work aims to explore the effects of (equity and non-equity) strategic alliances between banks and FinTechs on FinTechs' online visibility.

For a sample of 124 Italian FinTechs, the authors measured online visibility through their website ranking (Google PageRank) and website traffic (Google Trends). Consistent to the historical depth of these measures, the authors separately investigated the effect of equity and non-equity (contractual) agreements on online visibility by means of ordinal logistic regressions and diff-in-diff analysis.

Strategic alliances with banks enhance FinTechs' online visibility. Although both equity and contractual agreements positively influence the popularity of FinTechs' website achieved through the activity of internal and external online content creators (websites ranking), only equity agreements are effective in attracting Internet users (website traffic).

When deciding to interact with banks, FinTechs' managers should consider that equity agreements may be a powerful strategic choice for enlarging the customer base and boosting visibility of FinTechs.

Fostering strategic alliances between banks and FinTechs contributes to FinTechs' growth, generating virtuous mechanisms of innovation, financial inclusion and better allocative efficiency of the financial system.

This work expands marketing knowledge and literature regarding online visibility determinants, by investigating the benefits of strategic alliances and cooperation in the market, while providing an empirical strategy replicable by future marketing studies.

The childbirth process is a complex and vital event that requires careful analysis and improvement. This experience can shape a woman's perspective on motherhood and even affect her mental health. Healthcare providers must prioritize improving the birth experience for women. In this interdisciplinary research, a combination of business process modeling (BPM) and medicine have been used with the aim of realizing an improved delivery experience and increased maternal satisfaction.

The data collection of this study was done by observing 518 childbirth processes and interviewing the chief of labor, chief residents, and midwives in the obstetrics and gynecology department of a hospital in Tehran from October 2022 to February 2023.

The research has been done in four main stages. The first phase is to model the primary process and sub-processes of normal vaginal delivery (NVD). The second phase is validation using expert confirmation and process mining (PM). The third phase is the analysis of the causes of maternal dissatisfaction in labor. The fourth phase of the heuristics redesigning and improving the process, in which for the first time three new categories have been presented including hospital-based, patient-based, and medical technique-based results show BPM intervention effect can be far-reaching in improving patient care and optimizing operational efficiency.

This study is one of only a few to adopt a process-oriented perspective to show how BPM can be used in clinical processes and has specifically examined an essential clinical process, i.e. childbirth.

1. Developing business process management (BMP) applications in a medical special process related to childbirth as interdisciplinary research.

2. A combination of qualitative and quantitative techniques contains engineering software and management approaches for a Case study, Implementation of BPM lifecycle in the women's hospital in Iran, Tehran, for a clinical process, which is called, normal vaginal delivery (NVD) process for fetal expulsion normally.

3. Modeling NVD clinical process and sub-process for the first time by BPMN2.0 notations in visual paradigm (VP) software and Validation of the made model with process mining (PM), by Disco process mining software. This was done through event log collection from HIS at the hospital.

4. Improving the childbirth process by redesigning heuristics and Introducing two new categories special for clinical process improvement for the first time.

5. Clinical process improvement heuristics obtained in this research are not consistent with the previous seven categories presented in previous studies such as Marlon Dumas' book. Therefore, we have introduced two new heuristics to redesign clinical processes compatible with medical centers, including hospital-based, patient-based, and medical technique-based.

6. Providing a framework for clinical process modeling and improvement containing steps and tools.

Developing business process management (BMP) applications in a medical special process related to childbirth as interdisciplinary research.

A combination of qualitative and quantitative techniques contains engineering software and management approaches for a Case study, Implementation of BPM lifecycle in the women's hospital in Iran, Tehran, for a clinical process, which is called, normal vaginal delivery (NVD) process for fetal expulsion normally.

Modeling NVD clinical process and sub-process for the first time by BPMN2.0 notations in visual paradigm (VP) software and Validation of the made model with process mining (PM), by Disco process mining software. This was done through event log collection from HIS at the hospital.

Improving the childbirth process by redesigning heuristics and Introducing two new categories special for clinical process improvement for the first time.

Clinical process improvement heuristics obtained in this research are not consistent with the previous seven categories presented in previous studies such as Marlon Dumas' book. Therefore, we have introduced two new heuristics to redesign clinical processes compatible with medical centers, including hospital-based, patient-based, and medical technique-based.

Providing a framework for clinical process modeling and improvement containing steps and tools.

Most UK ambulance services undertake remote assessments of 999 calls with nurses and paramedics to manage demand and reduce inappropriate hospital admissions. However, little is known about the differences in the types of cases managed by the two professions comparatively, their clinical outcomes, and the quality and safety they offer.

The retrospective descriptive study analysed data collected at Welsh Ambulance Services University NHS Trust (WAST) from prioritisation, triage, and audit tools between the 17th May 2022 to 8th November 2022. A total of 21,076 cases and 728 audits were included for review.

There was little difference in the type and frequency of the presenting complaints assessed, and clinical outcomes reached in percentage terms. Whilst paramedics had more highly compliant call audits and fewer non-compliant call audits, there was, again, little difference in percentage terms between the two, indicating positive levels of safety across the two professional groups.

There continues to be a substantial difference between UK paramedics to those in the Middle East, the United States, and some African nations, which may limit the applicability of findings. This study also looked at a six-month window from only one UK service using one type of prioritisation and triage tool. Future research could explore longer periods from multiple services using various tools. It is important to note that this study did not link outcome data with primary, secondary or tertiary care settings. Thus, it is impossible to determine if the level of care aligned closely with the final diagnosis.

The practical implications of this work include better workforce planning for agencies who have perhaps only employed one type of clinician or a reaffirmation to those who have employed both. The authors suggest that the training and education of both sets of clinicians could remain general in nature, with no overt requirement for specificity based on professional registration alone. Commissioners and stakeholders in the wider health economy should consider ensuring equitable access to alternative pathways for patients assessed by both nurses and paramedics.

It has been posited that UK nurses and paramedics are, by virtue of their consistency in education, skill set, licensure, and general experience, both able to achieve safe and effective remote outcomes in 999 settings. This study provides evidence to support that hypothesis. These results say more about the two professions' ability to work together rather than just the professions themselves. The multidisciplinary team approach is well-established in acute care settings, and is broadly considered to improve communication, coordination decision making, adherence to up-to-date treatment recommendations, and be positive for shared learning and development for younger colleagues.

Most UK services use a mix of nurses and paramedics; however, little is known about the differences in the types of cases managed by the two professions comparatively, their clinical outcomes, and the quality and safety they each offer. The most recent studies of this nature were published in 2003 and 2004 and looked only at low-acuity 999 calls when remote assessment was not even an established role for UK paramedics. This study updates the literature, identifies areas for future research, and applies to the international setting for the most part.

Lean Six Sigma (LSS) implementation follows a structured approach called define-measure-analyze-improve-control (DMAIC). Earlier research about its application in emergency healthcare services shows that it requires organizational transformation, which many healthcare setups find difficult. The Kotter change management model facilitates organizational transformation but has not been attempted in LSS settings till now. This study aims to integrate the LSS framework with the Kotter change management model to come up with an integrated framework that will facilitate LSS deployment in emergency health services.

Two-stage Delphi method was conducted by using a literature review. First, the success factors and barriers of LSS are investigated, especially from an emergency healthcare point of view. The features and benefits of Kotter's change management models are then reviewed. Subsequently, they are integrated to form a framework specific to LSS deployment in an emergency healthcare set-up. The elements of this framework are analyzed using expert opinion ratings. A new framework for LSS deployment in emergency healthcare has been developed, which can prevent failures due to challenges faced by organizations in overcoming resistance to changes.

The eight steps of the Kotter model such as establishing a sense of urgency, forming a powerful guiding coalition, creating a vision, communicating the vision, empowering others to act on the vision, planning for and creating short-term wins, consolidating improvements and producing still more change, institutionalizing new approaches are derived from the eight common errors that managers make while implementing change in the institution. The study integrated LSS principles and Kotter’s change management model to apply in emergency care units in order to reduce waste and raise the level of service quality provided by healthcare companies.

The present study could contribute knowledge to the literature by providing a framework to integrate lean management and Kotter's change management model for the emergency care unit of the healthcare organization. This framework guides decision-makers and organizations as proper strategies are required for applying lean management practices in any system.

The proposed framework is unique and no other study has prescribed any integrated framework for LSS implementation in emergency healthcare that overcomes resistance to change.

The emergence of the COVID-19 pandemic changed the way in which education was delivered in early 2020, and the impacts of these changes continue to be questionable. The aims of this study were to evaluate: (1) the results obtained by students of the Dentistry course in the progress test carried out both before and after the pandemic, (2) the results obtained by a specific group of students who took the test in 2019–2022, and compare their results and (3) subjects that showed a reduction in the percentage of correct answers when the two tests were compared.

The progress test consisting of 100 multiple choice questions was applied before and after the pandemic to all students in the Dentistry course. The analyses were performed using the IBM SPSS for Statistics v.26 software program. The level of significance of 5% was adopted (<0.05).

The test was applied to 320 students in 2019 and to 272 in 2022, of whom the sample of this study was composed. The mean score values in 2019 (M = 49.10; SD = 12.03) were significantly (p = 0.026) higher than those in the year 2022 (M = 46.97; SD = 12.15), with the disciplines in the area of specific knowledge showing a greater drop in the percentage of correct answers by students. This study showed that the emergency remote education had a negative effect on the academic performance of students, based on the progress testing as an evaluation method.

Many studies that assessed the impacts of the pandemic on teaching were focused on the opinions of students. However, the great advantage of our study was the use of a theoretical assessment tool to verify student performance. The post-pandemic landscape beckons for comprehensive inquiries into these domains. This type of research would be valuable for gathering evidence relative to the performance of students after the emergency remote education.

The future increase of chronic diseases in the world requires new challenges in the health domain to improve patients' care from the point of view of the organizational processes, clinical pathways and technological solutions of digital health. For this reason, the present paper aims to focus on the study and application of well-known clinical practices and efficient organizational approaches through an innovative model (TALIsMAn) to support new care process redesign and digitalization for chronic patients.

In addition to specific clinical models employed to manage chronic conditions such as the Population Health Management and Chronic Care Model, we introduce a Business Process Management methodology implementation supported by a set of e-health technologies, in order to manage Care Pathways (CPs) digitalization and procedures improvement.

This study shows that telemedicine services with advanced devices and technologies are not enough to provide significant changes in the healthcare sector if other key aspects such as health processes, organizational systems, interactions between actors and responsibilities are not considered and improved. Therefore, new clinical models and organizational approaches are necessary together with a deep technological change, otherwise, theoretical benefits given by telemedicine services, which often employ advanced Information and Communication Technology (ICT) systems and devices, may not be translated into effective enhancements. They are obtained not only through the implementation of single telemedicine services, but integrating them in a wider digital ecosystem, where clinicians are supported in different clinical steps they have to perform.

The present work defines a novel methodological framework based on organizational, clinical and technological innovation, in order to redesign the territorial care for people with chronic diseases. This innovative ecosystem applied in the Italian research project TALIsMAn is based on the concept of a continuum of care and digitalization of CPs supported by Business Process Management System and telemedicine services. The main goal is to organize the different socio-medical activities in a unique and integrated IT system that should be sustainable, scalable and replicable.

This study investigated two key aspects: (1) how a hospital bundles limited resources for preventive care performance and (2) how to develop IS capabilities to enhance preventive care performance.

A case study method was adopted to examine how a hospital integrates its limited resources which leads to the need for resource bundles and an understanding of IS capabilities development to understand how they contribute to the delivery of preventive care in a Malaysian hospital.

This research proposes a comprehensive framework outlining resource-bundling and IS capabilities development to improve preventive care.

We acknowledge that the problem of transferring and generalizing results has been a common criticism of a single case study. However, our objective was to enhance the reader’s understanding by including compelling, detailed narratives demonstrating how our research results offer practical examples that can be generalized theoretically. The findings also apply to similar-sized public hospitals in Malaysia and other developing countries, facing challenges like resource constraints, HIS adoption levels, healthcare workforce shortages, cultural and linguistic diversity, bureaucratic hurdles, and specific patient demographics and health issues. Further, lessons from this context can be usefully applied to non-healthcare service sector domains.

This study provides a succinct strategy for enhancing preventive care in Malaysian public hospitals, focusing on system integration and alignment with hospital strategy, workforce diversity through recruitment and mentorship, and continuous training for health equity and inclusivity. This approach aims to improve resource efficiency, communication, cultural competence, and healthcare outcomes.

Efficiently using limited resources through HIS investment is essential to improve preventive care and reduce chronic diseases, which cause approximately nine million deaths annually in Southeast Asia, according to WHO. This issue has significantly impacted the socioeconomic development of developing countries.

This research refines resource orchestration theory with new mechanisms for resource mobilization, extends IS literature by identifying how strategic bundling forms specialized healthcare IS capabilities, enriches preventive care literature through actionable resource-bundling activities, and adds to HIS literature by advocating for an integrated, preventive care focus from the alignment of HIS design, people and institutional policies to address concerns raised by other research regarding the utilization of HIS in improving the quality of preventive care.