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Assess the realistic impacts of implementing an Radio Frequency Identification (RFID)/Internet of Things (IoT) uniforms’ distribution system for managing medical personnel’s scrubs in operating rooms. The authors use a hybrid simulation framework to address the following objectives and challenges: a) reduce and control operating rooms’ level of inventory; b) stabilize scrubs’ demand and c) improve infection control and prevention of cross-contamination (through scrubs over manipulation and hoarding).

The authors adopt a Design Science approach. This methodological approach is used to design, develop, create and evaluate information technology “artifacts” (e.g. constructs, models, methods and instantiations) intended to solve organizational problems and make research contributions (Peffers et al., 2007). More specifically, the authors follow the Design Science Research Methodology process model which includes six steps: problem identification and motivation, definition of the objectives for a solution, design and development, demonstration, evaluation, and communication.

To assess the realistic impacts of implementing an RFID-IoT uniforms’ distribution system for managing medical personnel’s scrubs in operating rooms, the authors adopted a design science approach and initiated the research by documenting the business case and reviewed the existing literature to build a comparative analysis of existing uniforms’ distribution systems. The authors used a hybrid simulation model to assess the impact of three business cases: present mode of operation, implementing smart shelves or the smart distributors. The authors show that smart dispensers allow a greater control on scrubs’ utilization while eliminating the cross-contamination of the medical personnel.

Through this research study, the authors provide hospitals’ managers a scientific support for uniforms’ (scrubs) distribution process improvement. The authors use a hybrid simulation model to compare innovative solutions for uniforms’ distribution systems in the form of “smart cabinets” supported by Radio Frequency Identification (RFID)/Internet of Things (IoT) technologies and choose the most appropriate design for the hospital to meet two main challenges: a) inefficiency of uniform replenishment-distribution system and b) noncompliancy with infection control regulations caused by the distribution system.

From a methodological perspective, this paper addresses concerns from researchers calling quantitative research methods and using case-based research strategy to address IoT issues and assess the system in practice. From a broader point of view, this work confirms the predominant interest of RFID-IoT research work in the arena of supply chain management and logistics as the technology is used for tracking purpose and for monitoring applications. It is also one response to the research community suggesting that “hospitals should evaluate the medical effectiveness of the new technologies as well as the cost before adoption”.

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 presented the experience of improving the nucleic acid sample collection and transportation service in response to the epidemic. The main purpose is that through intelligent path planning, combined with the time scheduling of sample points, the process of obtaining results to determine the state of COVID-19 patients could be speeding up.

The research optimized the process, including finding an optimal path to traverse all sample points in the hospital area via intelligent path planning method and standardizing the operation through the time sequence scheduling of each round of support staff to collect and send samples in the hospital area, so as to ensure the shortest time in each round. And the study examines these real-time experiments through retrospective examination.

The real-time experiments' data showed that the proposed path planning and scheduling model could provide a reliable reference for improving the efficiency of hospital logistics. Testing is a very important part of diagnosis and prompt results are essential. It shows the possibility of applying the shortest-path algorithms to optimize sample collection processes in the hospital and presents the case study that gives the expected outcomes of such a process.

The value of the study lies in the abstraction of a very practical and urgent problem into a TSP. Combining the ant colony algorithm with the genetic algorithm (ACAGA), the performance of path planning is improved. Under the intervention and guidance, the efficiency of hospital regional logistics planning was greatly improved, which may be of greater benefit to critical patients who must go through fever clinic during the epidemic. By detailing how to more rapidly obtain results through engineering method, the paper contributes ideas and plans for practitioners to use. The experience and lessons learned from Tongji Hospital are expected to provide guidance for supporting service measures in national public health infrastructure management and valuable reference for the development of hospitals in other countries or regions.

The purpose of this paper is to report on the implementation of the World Health Organization (WHO) trauma care checklist (TCC) (WHO, 2016) in an emergency department in a tertiary hospital in Nepal. This research was undertaken as part of a Hybrid International Emergency Medicine Fellowship programme (Subedi et al., 2020) across UK and Nepal, incorporating a two-year rotation through the UK National Health Service, via the Medical Training Initiative (MTI) (AoMRC, 2017). The WHO TCC can improve outcomes for trauma patients (Lashoher et al., 2016); however, significant barriers affect its implementation worldwide (Nolan et al., 2014; Wild et al., 2020). This article reports on the implementation, barriers and recommendations of WHO TCC implementation in the context of Nepal and argues for Transformational Leadership (TL) to support its implementation.

Explanatory mixed methods research (Creswell, 2014), comprising quasi-experimental research and a qualitative online survey, were selected methods for this research. A training module was designed and implemented for 10 doctors and 15 nurses from a total of 76 (33%) of clinicians to aid in the introduction of the WHO TCC in an emergency department in a hospital in Nepal. The quasi-experimental research involved a pre- and post-training survey aimed to assess participant’s knowledge of the WHO TCC before and after training and before the implementation of the WHO TCC in the emergency department. Post-training, 219 patients were reviewed after four weeks to identify if process measures had improved the quality of care to trauma patients. Subsequently six months later, a qualitative online survey was sent to all clinical staff in the department to identify barriers to implementation, with a response rate of 26 (n = 26) (34%) (20 doctors and 6 nurses). Descriptive statistics were used to evaluate quantitative data and the qualitative data were analysed using the five stepped approach of thematic analysis (Braun and Clarke, 2006).

The evaluation of the implementation of the WHO TCC showed an improvement in care for trauma patients in an emergency setting in a tertiary hospital in Nepal. There were improvements in the documentation in trauma management, showing the training had a direct impact on the quality of care of trauma patients. Notably, there was an improvement in cervical spine examination from 56.1% before training to 78.1%; chest examination 125 (57.07%) before training and 170 (77.62%) post-training; abdominal examination 121 (55.25%) before training and 169 (77.16%) post-training; gross motor examination 13 (5.93%) before training and 131 (59.82%) post-training; sensory examination 4 (1.82%) before training and 115 (52.51%) post-training; distal pulse examination 6 (2.73%) before training and 122 (55.7%) post-training. However, while the quality of documentation for trauma patients improved from the baseline of 56%, it only reached 78% when the percentage improvement target agreed for this research project was 90%. The 10 (n = 10) doctors and 15 (n = 15) nurses in the Emergency Department (ED) all improved their baseline knowledge from 72.2% to 87% (p = 0.00006), by 14.8% and 67% to 85%) (p = 0.006), respectively. Nurses started with lower scores (mean 67) in the baseline when compared to doctors, but they made significant gains in their learning post-training. The qualitative data reported barriers, such as the busyness of the department, with residents and medical officers, suggesting a shortened version of the checklist to support greater protocol compliance. Embedding this research within TL provided a steer for successful innovation and change, identifying action for sustaining change over time.

The study is a single-centre study that involved trauma patients in an emergency department in one hospital in Nepal. There is a lack of internationally recognised trauma training in Nepal and very few specialist trauma centres; hence, it was challenging to teach trauma to clinicians in a single 1-h session. High levels of transformation of health services are required in Nepal, but the sample for this research was small to test out and pilot the protocol to gain wider stakeholder buy in. The rapid turnover of doctors and nurses in the emergency department, creates an additional challenge but encouraging a multi-disciplinary approach through TL creates a greater chance of sustainability of the WHO TCC.

International protocols are required in Nepal to support the transformation of health care. This explanatory mixed methods research, which is part of an International Fellowship programme, provides evidence of direct improvements in the quality of patient care and demonstrates how TL can drive improvement in a low- to medium-income country.

The Nepal/UK Hybrid International Emergency Medicine Fellowships have an opportunity to implement changes to the health system in Nepal through research, by bringing international level standards and protocols to the hospital to improve the quality of care provided to patients.

To the best of the authors’ knowledge, this research paper is one of the first studies of its kind to demonstrate direct patient level improvements as an outcome of the two-year MTI scheme.

To explore the perceptions of surgical team members in a tertiary hospital in Jordan toward the factors influencing patient safety culture (PSC).

This was a qualitative descriptive study intended to characterize the factors that influence PSC. Interviews were conducted with health-care providers in the operation room (OR) in a tertiary Jordanian hospital. Participants included surgeons, anesthetists, nurses and senior surgical residents who had worked for three years minimum in the OR. Thematic analysis was used to analyze the data.

A total of 33 interviews were conducted. Thematic analysis of the content yielded four major themes: (1) operational factors, (2) organizational factors, (3) health-care professionals factors and (4) patient factors. The respondents emphasized the role of the physical layout of the OR, implementing new techniques and new equipment, and management support to establish a safety culture in the operating room setting.

The present research study will have implications for hospitals and health-care providers in Jordan for developing organizational strategies to eliminate or decrease the occurrence of adverse events and improve patient safety in the OR.

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.

The purpose of this paper is to estimate the possible impact of the COVID-19 pandemic on the hospitalization and hospital mortality of the patients with gallstone disease and chronic liver diseases (CLD) in the worst pandemic period in Ukraine.

A retrospective comparative analysis of annual reports data of all economy subjects, which conducted economic activity in medical practice for 2019 and 2021. Data was accepted from the Ministry of Health of Ukraine, the National Security and Defense Council of Ukraine (NSDC) and the State Statistics Service of Ukraine (SSSU).

The total hospitalization rates for diffuse liver disease and cholelithiasis significantly decreased during the peak of the COVID-19 pandemic in Ukraine, compared to the values of 2019. At the same time, the rates of in-hospital mortality for these diseases have significantly grown. Also, various proportions of similar trends were described in other countries during the first wave of the pandemic.

This paper highlights the fact that regulatory restrictions and the fear of the population of referring to healthcare facilities considering the high risk of getting an infection had significant disruption to medical care for patients with gallstone disease and CLD. Improving the management of medical resources and strengthening all kinds of institutions in the healthcare system must be thought about if similar challenges appear in the future.

In Japan, health-care systems have long been supported by physicians' long working hours. To solve this problem, there is an urgent need to improve the working environment for physicians while practicing patient-centered medicine and controlling health-care costs. This paper aims to examine the effect of task shifting to nurses and discuss its usefulness from the perspective of health-care value co-creation.

This paper analyzes task shifting to nurses in acute care hospitals in Japan as a solution for the shortage of anesthesiologists. The authors discuss how the value was created from the perspective of the health-care ecosystem, with conceptual consideration of the value co-creation mechanism through patient-centered practices.

The study showed that task shifting initiatives in Japan can improve the motivation of nurses through human resource development while maintaining high quality. The study also suggested that task shifting from physicians to nurses may contribute to improving net income and maintaining the health-care system.

The findings are highly reproducible and can be immediately applied to initiatives at other medical institutions in Japan. Furthermore, it is suggested that these findings might provide some perspective on the realignment of fragmented healthcare in the USA.

It was confirmed in practical terms that micro-level initiatives have an impact on the macro level as well. In addition, the academic presentation of the concept has contributed to the deepening of value research.

This paper investigates how agile capabilities in humanitarian settings work in combination, and its effects on performance outcome. The study was conducted in the frame of reference of response operations during cyclones and floods, which is considered most complex and with the most widespread impact.

A survey-based method was used to collect empirical data on response operations from 131 field officers who were involved in disaster response during cyclones or floods. A partial least square based structural equation model was used to study the path model of interaction of agile capabilities, and their effect on performance outcomes.

The results show that integration of agile capabilities is important for enhancing effectiveness of humanitarian response. The results indicated a serial mediation effect involving visibility, responsiveness and flexibility capability on the effectiveness of emergency response.

This research has implications for response units of humanitarian organisations. This includes capacity building for key agile capabilities, integration, supply chain re-configuration and differential positioning of response phase as against preparedness and recovery phases.

This study is unique for the chosen humanitarian setting, which is considered most difficult. The authors demonstrate from empirical evidence the interaction effects of agile capabilities during response phase for cyclones and floods, and their impact. The research insights will help practitioners to configure and position supply chains for better effectiveness during response operations, which have markedly different objectives vis-à-vis other phases or types of humanitarian settings.