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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.

As research emerged in terms of how narcissism, a negative or dark trait, has been found to be constructive in enhancing entrepreneurial behaviour, there are mixed results regarding the significance of narcissism in the field of entrepreneurship. Additionally, this previous research has mostly been conducted on student or nascent entrepreneur samples within developed economies. Therefore, the purpose of this paper is to explore how narcissistic traits of established entrepreneurs in an emerging economy context infuence their entrepreneurial behaviour both positively and negatively.

Gioia methodology was applied in the qualitative study by means of in-depth interviews, which allowed for the unpacking of narcissistic traits among established entrepreneurs in South Africa. Four themes emerged from the data, and included insights related to entrepreneurial experience influencing behaviour; business growth linked to personal development; opportunity identification versus loss; and identity separation in relation to authentic identity versus an entrepreneurial identity.

The findings of the paper contribute to creating an understanding of how to hone individual narcissistic traits for positive influences that develop entrepreneurs while also contributing to their business development, opportunity realization and identity. In addition, the findings highlighted a separation between established entrepreneurs’ authentic personality and the inputs that end up resulting in the entrepreneurial personality.

This paper highlights the possibility of narcissism functioning as a business process involved in entrepreneurship rather than a necessary personality trait. An interesting dynamic contributed to what seems to be a constant battle between the authentic identity and the entrepreneur identity, gaining deeper insight surrounding established entrepreneurs’ experiences to survive and, more importantly, thrive as entrepreneurs.

People with intellectual disability die prematurely and from avoidable causes. Innovative solutions and proactive strategies have been limited in addressing this disparity. This paper aims to detail the process of developing a risk stratification tool to identify those individuals who are higher risk of premature mortality.

This study used population health management principles to conceptualise a risk stratification tool for avoidable deaths in people with intellectual disability. A review of the literature examined the existing evidence of causes of death in people with intellectual disability. A qualitative methodology using focused groups of specialist clinicians was used to understand the factors that contributed towards avoidable deaths in people with intellectual disability. Delphi groups were used for consensus on the variables for inclusion in the risk stratification tool (Decision Support Tool for Physical Health).

A pilot of the Decision Support Tool for Physical Health within specialist intellectual disability service demonstrated effective utility and acceptability in clinical practice. The tool has also demonstrated good face and construct validity. A further study is currently being completed to examine concurrent and predictive validity of the tool.

To the best of the authors’ knowledge, this is the only study that has used a systematic approach to designing a risk stratification tool for identifying premature mortality in people with intellectual disability. The Decision Support Tool for Physical Health in clinical practice aims to guide clinical responses and prioritise those identified as at higher risk of avoidable deaths.