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The purpose of this study is to explore the sustainability of innovations introduced during the coronavirus disease 2019 (Covid-19) pandemic in remote and rural primary care advanced clinical practice.

The methodology includes an exploratory qualitative study of eight key stakeholders from Scottish remote and rural primary care advanced practice (three policymakers and five advanced practitioners). Data were collected using semi-structured interviews during 2022 and analysed thematically.

Advanced practice in remote and rural primary care is characterised by a shortage of doctors, close-knit communities and a broad scope of practice. Covid-19 catalysed changes in the delivery of healthcare. Innovations which participants wanted to sustain include hybrid working, triage, online training and development, and increased inter-professional support networks.

Findings provide valuable insights into how best to support remote and rural advanced practice which may have implications for retaining healthcare professionals. They also identified useful innovations which could benefit from further investment.

Given current healthcare workforce pressures, identifying and sustaining innovations which will support and retain staff are imperative. Hybrid consultations and online access to training, development and support should be sustained to support the remote and rural advanced practice workforce. Further research should explore the sustainability of innovations introduced during the Covid-19 pandemic in other care contexts.

Since 2018, Australian paramedics have been regulated under the National Registration and Accreditation Scheme (NRAS) for health practitioners. Established professions have been regulated in Australia for some time, so there is limited knowledge of their entry to regulation. However, as paramedicine has not been previously centrally regulated, this provides a unique case study to explore the transition to regulated practice.

Australian paramedics undertook two surveys: pre- and post-introduction of registration. The first survey was in the month leading up to the commencement of registration (N = 419), and the second survey took place 31 months after registration (N = 407). This paper presents the results of statistical analyses of the post-registration survey including comparisons to the pre-registration survey.

Although support for regulation has increased over time, there remains strong dissent consistent with 2018 levels. After 31 months of regulation, respondents reported increasing knowledge of the scheme and greater ease of navigation. The impacts of regulation are more nuanced and less polarised than in the first survey. Identity is again canvassed, and results suggest a shift from employment status and qualifications as key elements of identity to a community of practice and registration.

Paramedics' experiences and understanding of the rationale for registration are developing. Further support is needed to assist with the emerging professional identity and behaviours. Regulation is one of many occupational factors influencing professional identity and professionalism. Exploring the experience of regulation potentially assists regulators in better supporting practitioners and helps better understand professional evolution.

Recently, powerful instruments for biomedical engineering research studies, including disease modeling, drug designing and nano-drug delivering, have been extremely investigated by researchers. Particularly, investigation in various microfluidics techniques and novel biomedical approaches for microfluidic-based substrate have progressed in recent years, and therefore, various cell culture platforms have been manufactured for these types of approaches. These microinstruments, known as tissue chip platforms, mimic in vivo living tissue and exhibit more physiologically similar vitro models of human tissues. Using lab-on-a-chip technologies in vitro cell culturing quickly caused in optimized systems of tissues compared to static culture. These chipsets prepare cell culture media to mimic physiological reactions and behaviors.

The authors used the application of lab chip instruments as a versatile tool for point of health-care (PHC) applications, and the authors applied a current progress in various platforms toward biochip DNA sensors as an alternative to the general bio electrochemical sensors. Basically, optical sensing is related to the intercalation between glass surfaces containing biomolecules with fluorescence and, subsequently, its reflected light that arises from the characteristics of the chemical agents. Recently, various techniques using optical fiber have progressed significantly, and researchers apply highlighted remarks and future perspectives of these kinds of platforms for PHC applications.

The authors assembled several microfluidic chips through cell culture and immune-fluorescent, as well as using microscopy measurement and image analysis for RNA sequencing. By this work, several chip assemblies were fabricated, and the application of the fluidic routing mechanism enables us to provide chip-to-chip communication with a variety of tissue-on-a-chip. By lab-on-a-chip techniques, the authors exhibited that coating the cell membrane via poly-dopamine and collagen was the best cell membrane coating due to the monolayer growth and differentiation of the cell types during the differentiation period. The authors found the artificial membrane, through coating with Collagen-A, has improved the growth of mouse podocytes cells-5 compared with the fibronectin-coated membrane.

The authors could distinguish the differences across the patient cohort when they used a collagen-coated microfluidic chip. For instance, von Willebrand factor, a blood glycoprotein that promotes hemostasis, can be identified and measured through these type-coated microfluidic chips.

Designing and developing safe systems has been a persistent challenge in health care, and in surgical settings in particular. In efforts to promote safety, safety culture, i.e., shared values regarding safety management, is considered a key driver of high-quality, safe healthcare delivery. However, changing organizational culture so that it emphasizes and promotes safety is often an elusive goal. The Safe Surgery Checklist is an innovative tool for improving safety culture and surgical care safety, but evidence about Safe Surgery Checklist effectiveness is mixed. We examined the relationship between changes in management practices and changes in perceived safety culture during implementation of safe surgery checklists. Using a pre-posttest design and survey methods, we evaluated Safe Surgery Checklist implementation in a national sample of 42 general acute care hospitals in a leading hospital network. We measured perceived management practices among managers (n = 99) using the World Management Survey. We measured perceived preoperative safety and safety culture among clinical operating room personnel (N = 2,380 (2016); N = 1,433 (2017)) using the Safe Surgical Practice Survey. We collected data in two consecutive years. Multivariable linear regression analysis demonstrated a significant relationship between changes in management practices and overall safety culture and perceived teamwork following Safe Surgery Checklist implementation.

Effective use of data is critically important for the provision of health services. A large proportion of employees in health organisations work in non-clinical roles and play a major part in organisational information flows. However, their practice, data-related capabilities and learning needs have been rarely studied. The purpose of this paper is to investigate issues of capabilities and learning needs related to employees' interactions with data in non-clinical work roles.

The study used a mixed-method approach. Qualitative methods were used to explore issues, and survey was administered to gather additional data.

Data use and related capabilities at the workplace are highly contextual. A range of general, core and data-specific capabilities, underpinned by transferable skills and personal traits, enable successful interactions with data. Continuous learning is needed in most areas related to data use.

The study was conducted in a large public-health organisation in Australia, which is not representative of unique organisations elsewhere. The study has implications for the provision of health services, workplace learning and education.

Findings have implications for organisational decisions related to data-use and workplace learning, and for formal education and lifelong learning.

The study contributes to closing a research gap in understanding interactions with data, capabilities and learning needs of employees in non-clinical work roles. Capabilities continuum presented in this paper can be used to inform education, training and service provision. The workplace-based results contribute to theoretical considerations of capabilities required for work in technology-rich environments.

The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.

The methodology entails the integration of service design (SD) and action research (AR) methodologies, characterized by iterative phases that systematically alternate between action and reflective processes, fostering cycles of change and learning. Within this framework, stakeholders are engaged through semi-structured interviews, while the existing and envisioned processes are delineated and represented using BPMN 2.0. These methodological steps emphasize the development of an autonomous, patient-centric web application alongside the implementation of an adaptable and patient-oriented scheduling system. Also, business processes simulation is employed to measure key performance indicators of processes and test for potential improvements. This method is implemented in the context of the CP addressing transient loss of consciousness (TLOC), within a publicly funded hospital setting.

The methodology integrating SD and AR enables the detection of pivotal bottlenecks within diagnostic CPs and proposes optimal corrective measures to ensure uninterrupted patient care, all the while advancing the digitalization of diagnostic CP management. This study contributes to theoretical discussions by emphasizing the criticality of process optimization, the transformative potential of digitalization in healthcare and the paramount importance of user-centric design principles, and offers valuable insights into healthcare management implications.

The study’s relevance lies in its ability to enhance healthcare practices without necessitating disruptive and resource-intensive process overhauls. This pragmatic approach aligns with the imperative for healthcare organizations to improve their operations efficiently and cost-effectively, making the study’s findings relevant.

This paper aims to describe the design and evaluation of a pilot leadership development programme for infection prevention and control (IPAC) professionals during the COVID-19 pandemic. The programme’s aim was to improve IPAC knowledge and capacity in the health-care system by developing the leadership skills and capacities of novice and advanced Infection Control Professionals (ICPs), to respond flexibly, and competently, in their expanding and ever-changing roles.

The leadership programme was piloted with seven nurses, who were part of a clinical nursing team in New South Wales, Australia, over a 12-month period between 2021 and 2022. The programme was designed using a leadership development framework underpinned by transformational leadership theory, practice development approaches and collaborative and experiential learning. These principles were applied during programme design, with components adapted to learners’ interests and regular opportunities provided for collaboration in active learning and critical reflection on workplace experiences.

The authors’ evaluation suggests that the programme was feasible, acceptable and considered to be effective by this cohort. Moreover, participants valued the opportunities to engage in active and experience-based learning with peers, and with the support of senior and experienced ICPs. The action learning sets were well-received and allowed participants to critically reflect on and learn from one another’s experiences. The mentoring programme allowed them to apply their developing leadership skills to real workplace challenges that they face.

Despite a small sample size, the authors’ results provide empirical evidence about the effectiveness of using a practice development approach for strengthening ICP leadership capacity. The success of this pilot study has paved the way for a bigger second cohort of participants in the programme, for which further evaluation will be conducted.

The success of this leadership programme reflects both the need for leadership development in the IPAC professions and the applicability of this approach, with appropriate facilitation, for other professions and organizations.

ICP leadership programmes have not been previously reported in the literature. This pilot study builds on the growing interest in IPAC leadership to foster health system responsiveness and change.

The purpose of the paper is to present an integrated methodology for identifying trends in a particular subject area based on a combination of advanced text mining and expert methods. The authors aim to test it in an area of clinical psychology and psychotherapy in 2010–2019.

The authors demonstrate the way of applying text-mining and the Word2Vec model to identify hot topics (HT) and emerging trends (ET) in clinical psychology and psychotherapy. The analysis of 11.3 million scientific publications in the Microsoft Academic Graph database revealed the most rapidly growing clinical psychology and psychotherapy terms – those with the largest increase in the number of publications reflecting real or potential trends.

The proposed approach allows one to identify HT and ET for the six thematic clusters related to mental disorders, symptoms, pharmacology, psychotherapy, treatment techniques and important psychological skills.

The developed methodology allows one to see the broad picture of the most dynamic research areas in the field of clinical psychology and psychotherapy in 2010–2019. For clinicians, who are often overwhelmed by practical work, this map of the current research can help identify the areas worthy of further attention to improve the effectiveness of their clinical work. This methodology might be applied for the identification of trends in any other subject area by taking into account its specificity.

The paper demonstrates the value of the advanced text-mining approach for understanding trends in a subject area. To the best of the authors’ knowledge, for the first time, text-mining and the Word2Vec model have been applied to identifying trends in the field of clinical psychology and psychotherapy.

The paper contributes to the discussion on valuation in organization studies and strategic management literature. The nascent literature on valuation practices has examined established markets where producers and consumers are known and rivalry in the market is a given. Furthermore, previous research has operated with a narrow meaning of value as either a financial profit or a subjective consumer preference. Such a narrow view on value is problematic and insufficient for studying the interlacing of innovation and value creation in emerging technoscientific business domains.

The authors present an empirical study about value creation in an emerging technoscience business domain formed around personalized medicine and digital health data.

The results of this analysis show that in a technoscientific domain, valuation of innovations is multiple and malleable, entails pursuing attractiveness in collaboration and partnerships and is performative, and due to emphatic future orientation, values are indefinite and promissory.

As research implications, this study shows that valuation practices in an emerging technoscience business domain focus on defining the potential economic value in the future and attracting partners as probable future beneficiaries. Commercial value upon innovation in an embryonic business milieu is created and situated in valuation practices that constitute the prospective market, the prevalent economic discourse, and rationale. This is in contrast to an established market, where valuation practices are determined at the intersection of customer preferences and competitive arenas where suppliers, producers, service providers and new entrants to the market present value propositions.

The study findings extend discussion on valuation from established business domains to emerging technoscience business domains which are in a “pre-competition” phase where suppliers, customers, producers and their collaborative and competitive relations are not yet established.

As managerial implications, this study provides insights into health innovation stakeholders, including stakeholders in the public, private and academic sectors, about the ecosystem dynamics in a technoscientific innovation. Such insight is useful in strategic decision-making about ecosystem strategy and ecosystem business model for value proposition, value creation and value capture in an emerging innovation domain characterized by collaborative and competitive relations among stakeholders. To business managers, the findings of this study about valuation practices are useful in strategic decision-making about ecosystem strategy and ecosystem business model for value proposition, value creation and value capture in an emerging innovation domain characterized by collaborative and competitive relations among stakeholders. To policy makers, this study provides an in-depth analysis of an overall business ecosystem in an emerging technoscience business that can be propelled to increase the financial investments in the field. As a policy implication, this study provides insights into the various dimensions of valuation in technoscience business to policy makers, who make governance decisions to guide and control the development of medical innovation using digital health data.

This study's results expand previous theorizing on valuation by showing that in technoscientific innovation all types of value created – scientific, clinical, social or economic – are predominantly promissory. This study complements the nascent theorizing on value creation and valuation practices of technoscientific innovation.

Diffusion of innovations, defined as the adoption and implementation of new ideas, processes, products, or services in health care, is both particularly important and especially challenging. One known problem with adoption and implementation of new technologies is that, while organizations often make innovations immediately available, organizational actors are more wary about adopting new technologies because these may impact not only patients and practices but also reimbursement. As a result, innovations may remain underutilized, and organizations may miss opportunities to improve and advance. As innovation adoption is vital to achieving success and remaining competitive, it is important to measure and understand factors that impact innovation diffusion. Building on a survey of a national sample of 654 clinicians, our study measures the extent of diffusion of value-enhancing care delivery innovations (i.e., technologies that not only improve quality of care but has potential to reduce care cost by diminishing waste, Faems et al., 2010) for 13 clinical specialties and identifies healthcare-specific individual characteristics such as: professional purview, supervisory responsibility, financial incentive, and clinical tenure associated with innovation diffusion. We also examine the association of innovation diffusion with perceived value of one type of care delivery innovation – artificial intelligence (AI) – for assisting clinicians in their clinical work. Responses indicate that less than two-thirds of clinicians were knowledgeable about and aware of relevant value-enhancing care delivery innovations. Clinicians with broader professional purview, more supervisory responsibility, and stronger financial incentives had higher innovation diffusion scores, indicating greater knowledge and awareness of value-enhancing, care delivery innovations. Higher levels of knowledge of the innovations and awareness of their implementation were associated with higher perceptions of the value of AI-based technology. Our study contributes to our knowledge of diffusion of innovation in healthcare delivery and highlights potential mechanisms for speeding innovation diffusion.