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To facilitate the reception and care of discharged patients, streamlining processes at the University Hospital and promoting a seamless transition to continuity of care services post-discharge.

Hospitalised patients undergo the Blaylock risk assessment screening score (BRASS), a screening tool identifying those at risk of complex discharge.

Pre-pandemic, patients with a medium-to-high risk of complex discharge were predominantly discharged to their residence or long-term care facilities. During the pandemic, coinciding with an overall reduction in hospitalisation rates, there was a decrease in patients being discharged to their residence.

The analysis of discharges, with the classification of patients into risk groups, revealed a coherence between the BRASS score and the characteristics of the studied sample. This tool aids physicians in decision-making by identifying the need for a planned discharge in a systematic and organised manner, preventing the loss of crucial information.

Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a shift from acute, episodic and reactive hospital-centered care toward longitudinal, person-centered and proactive home-centered care. The purpose of this paper is to contribute to the knowledge of a comprehensive development strategy for designing and providing home-centered care of older people.

The study design is based on qualitative research with an inductive approach. The authors study development initiatives at the national, regional and local levels of the Swedish health and social care system. The data collection methods included interviews (n = 54), meeting observations (n = 25) and document studies (n = 59).

The authors describe findings related to policy actions and system changes, attempts to achieve collaboration, integration and coordination, new forms of care offerings, characteristics of work settings at home and differences in patients' roles and participation at home and in the hospital.

The authors suggest home-centered care as a solution for providing person-centered and integrated care of older people and give examples of how this can be achieved.

The authors outline five propositions for research and development related to national policies, service modularity as a solution for customized and coordinated care, developing human resources and infrastructure for home settings, expanding services that enable older people living at home and patient co-creation.

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 research aims to explore the role of awareness of harm and responsibility for environmental protection in reducing pollution from single-use plastic bags (SPBs) in coastal communities (CCs). To this end, this study develops and tests a unique model that explains residents’ intention to reduce the use of SPBs in coastal regions.

A questionnaire was used to collect data from 721 coastal residents in Vietnam. Structural equation modeling and moderation analysis were applied to test the proposed hypotheses.

The results show that awareness of the impact of SPBs on the environment and human health and awareness of the responsibility to protect the coastal environment significantly affect attitudes and intentions to reduce the use of SPBs. Moreover, such awareness of responsibility strengthens the attitude-intention relationship.

The findings suggest that CCs should not receive a lower priority in campaigns and efforts to reduce SPBs. In this regard, providing residents with free environmentally friendly bags and education programs on the impact of SPBs could be implemented.

CCs are directly impacted by pollution from SPBs. However, little is known about how this affects their polluting behavior. This study shows that CCs are not immune to polluting behaviors and that SPBs can be significant among residents. It also demonstrates that awareness of harm and feeling responsible for the environment are essential drivers of (intended) sustainable behaviors.

This paper aims to identify the interplay of standard Capesize optimal speeds for time charter equivalent (TCE) maximization in the Australia–China iron ore route and the optimal speeds as an operational tool for compliance with the International Maritime Organization (IMO) carbon intensity indicator (CII).

The TCE at different speeds have been calculated for four standard Capesize specifications: (1) standard Capesize with ecoelectronic engine; (2) standard Capesize with non-eco engine (3) standard Capesize vessel with an eco-electronic engine fitted with scrubber and (4) standard Capesize with non-eco engine and no scrubber fitted.

Calculations imply that in a highly inflationary bunker price context, the dollar per ton freight rates equilibrates at levels that may push optimal speeds below the speeds required for minimum CII compliance (C Rating) in the Australia–China trade. The highest deviation of optimal speeds from those required for minimum CII compliance is observed for non-eco standard Capesize vessels without scrubbers. Increased non-eco Capesize deployment would see optimal speeds structurally lower at levels that could offer CII ratings improvements.

While most of the studies have covered the use of speed as a tool to improve efficiency and emissions in the maritime sector, few have been identified in the literature to have examined the interplay between the commercial and operational performance in the dry bulk sector stemming from the freight market equilibrium. The originality of this paper lies in examining the above relation and the resulting optimal speed selection in the Capesize sector against mandatory environmental targets.

Using a mixed methodology comprising interviews, case file analysis and descriptive statistics, this study aims to examine the experiences of all 43 young people in Wales subject to secure accommodation orders between 1st April 2016 and 31st March 2018.

Children in the UK aged 10–17 years who are deemed to be at a significant level of risk to themselves or others may be subject to a secure accommodation order, leading to time spent in a secure children’s home (SCH) on welfare grounds. Following a rise in the number of children in Wales referred to SCHs for welfare reasons, this paper describes these young people’s journeys into, through and out of SCHs, giving insight into their experiences and highlighting areas for policy and practice improvements.

Findings indicate that improvements in mental health support and placement availability are key in improving the experiences of this particularly vulnerable group of young people throughout their childhood.

Other practical implications of the study’s findings, such as improvements in secure transport arrangements, are also discussed.

While the findings are limited by the reliance on self-report methods and the size of the study, namely, the small number of young people with experience of SCHs who were able to participate, the findings build on the existing knowledge base around children’s residential accommodation and provide new insights into how best to support these children.

Integrated care (IC) is mainly studied from the perspectives of organisations or employees. However, less research is focussed on how patients themselves experience person-centred (PC) IC in practice. This context-specific, small-scale study examines what PC-IC means to older patients who went through joint replacement surgery (JRS).

The data consists of ten in-depth interviews of older patients, focussing on their experiences of care during their patient journey related to joint knee or hip replacement surgery. The data were analysed with thematic analysis.

Three central dimensions of PC-IC for older patients were identified: information sharing, continuity of care and compassionate encountering. Human validation and compassionate encountering were experienced as important aspects of PC-IC. Compassionate encountering was concretised through professionals’ very small everyday practices, which made the patient feel comfortable and respected. Instead, probably due to the medical and quite straight-forward nature of the joint replacement care process, patients seem to be pleased to trust the expertise of professionals and did not necessarily expect an active role or participation in the decision-making.

This Finnish case study focusses on the patients’ authentic perceptions of what is central to person-centred IC in the specific context of JRS.

This study aims to facilitate access to vascular disease screening for low-income individuals living in remote and conflict areas based on the results of a pilot trial in Colombia. Also, to increase the amount of diagnosis training of vascular surgery (VS) in civilians.

The operation method includes five stages: strategy development and adjustment; translation of the strategy into a real-world setting; operation logistics planning; strategy analysis and adoption. The operation plan worked efficiently in this study’s sample. It demonstrated high sensibility, efficiency and safety in a real-world setting.

The authors developed and implemented a flow model operating plan for screening vascular pathologies in low-income patients pro bono without proper access to vascular health care. A total of 140 patients from rural areas in Colombia were recruited to a controlled screening session where they underwent serial noninvasive ultrasound assessments conducted by health professionals of different training stages in VS.

The plan was designed to be implemented in remote, conflict areas with limited access to VS care. Vascular injuries are critically important and common among civilians and military forces in regions with active armed conflicts. As this strategy can be modified and adapted to different medical specialties and geographic areas, the authors recommend checking the related legislation and legal aspects of the intended areas where we will implement this tool.

Different sub-specialties can implement the described method to be translated into significant areas of medicine, as the authors can adjust the deployment and execution for the assessment in peripheral areas, conflict zones and other public health crises that require a faster response. This is necessary, as the amount of training to which VS trainees are exposed is low. A simulated exercise offers a novel opportunity to enhance their current diagnostic skills using ultrasound in a controlled environment.

Evaluating and assessing patients with limited access to vascular medicine and other specialties can decrease the burden of vascular disease and related complications and increase the number of treatments available for remote communities.

It is essential to assess the most significant number of patients and treat them according to their triage designation. This management is similar to assessment in remote areas without access to a proper VS consult. The authors were able to determine, classify and redirect to therapeutic interventions the patients with positive findings in remote areas with a fast deployment methodology in VS.

Access to health care is limited due to multiple barriers and the assessment and response, especially in peripheral areas that require a highly skilled team of medical professionals and related equipment. The authors tested a novel mobile assessment tool for remote and conflict areas in a rural zone of Colombia.

Over a decade since the Special Criminal Court (SCC) was established in Cameroon, hundreds of individuals have been indicted, tried and convicted. Sentences have been imposed, most of which include a term of imprisonment (principal punishment/penalty) and confiscation as accessory penalty or punishment. Research focus has not been directed at the sentences which, as argued in this paper, are inconsistent, incommensurate with the amounts of money stolen and a significant departure from the Penal Code. This paper aims to explore the aspect of sentencing by the SCC.

To identify, highlight and discuss the issue of sentencing, the paper looks at a blend of primary and secondary materials: primary materials here include but not limited to the judgements of the SCC and other courts in Cameroon and the Penal Code. Secondary materials shall include the works of scholars in the fields of criminal law, criminal justice and penal reform.

A few findings were made: first, the judges are inconsistent in the manner in which they determine the appropriate sentence. Second, in making that determination, the judges would have been oblivious to the prescripts in the Penal Code, which provides the term of imprisonment, and in the event of a mitigating circumstance, the prescribed minimum to be applied. Yet, the default imposition of an aggravating circumstance (being a civil servant) was not explored by the SCC. Finally, whether the sentences imposed are commensurate with the amounts of monies stolen.

This research unravels key insights into the functioning of the SCC. It advances the knowledge thereon and adds to the literature on corruption in Cameroon.

The prosecution and judges at the SCC should deepen their knowledge of Cameroonian criminal law, especially on the nature of liberty given to judges to determine within the prescribed range of the sentence to be imposed but also consider the existence of an aggravating factor – civil servant. They must also consider whether the sentences imposed befit the crime for which they are convicted.

The paper is an original contribution with new insights on the manner in which sentencing should be approached by the SCC.

During the 1990s, Italian healthcare organisations (HOs) underwent a process of corporatisation, and the most innovative HOs introduced the balanced scorecard (BSC) to address the need for broader accountability. Currently, there is a limited understanding of the dynamics and outcomes of such a process. Therefore, this study aims to explore whether the BSC is still considered an effective performance management tool and analyse the factors driving and hindering its evolution and endurance in public and non-profit HOs.

We conducted a retrospective longitudinal analysis of two pioneering cases in the adoption of the BSC: one in a public hospital and the other in a non-profit hospital. Data collection relied on accessing institutional documents and reports from the early 2000s to the present, as well as conducting semi-structured interviews with the internal sponsors of the BSC.

We found evidence of three main categories of factors that trigger or hinder the adoption and development of the BSC: (1) the role of the internal sponsor and professionals’ commitment; (2) information technology and the controller’s technological skills; and (3) the relationship between the management and professionalism logics during the implementation process. At the same time, there is no evidence to suggest that specific technical features of the BSC influence its endurance.

The paper contributes to the debate on the key factors for implementing and sustaining multidimensional control systems in professional organisations. It emphasises the importance of knowledge-based assets and distinctive internal capabilities for the success of the business. The implications of the BSC legacy are discussed, along with future developments of multidimensional control tools aimed at supporting strategy execution.