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The purpose of this study is to introduce the top-level design ideas and the overall architecture of earthquake early-warning system for high speed railways in China, which is based on P-wave earthquake early-warning and multiple ways of rapid treatment.

The paper describes the key technologies that are involved in the development of the system, such as P-wave identification and earthquake early-warning, multi-source seismic information fusion and earthquake emergency treatment technologies. The paper also presents the test results of the system, which show that it has complete functions and its major performance indicators meet the design requirements.

The study demonstrates that the high speed railways earthquake early-warning system serves as an important technical tool for high speed railways to cope with the threat of earthquake to the operation safety. The key technical indicators of the system have excellent performance: The first report time of the P-wave is less than three seconds. From the first arrival of P-wave to the beginning of train braking, the total delay of onboard emergency treatment is 3.63 seconds under 95% probability. The average total delay for power failures triggered by substations is 3.3 seconds.

The paper provides a valuable reference for the research and development of earthquake early-warning system for high speed railways in other countries and regions. It also contributes to the earthquake prevention and disaster reduction efforts.

Accident emergency hospital (AEH) services require cohesive, collective, uninterrupted streamlined medical diagnostic and satisfactory patient care. Medical service efficiency in AEHs is difficult to quantify due to the clinical complexity involved in treatment involving various units, patient conditions, changes in contemporary medical practices and technological developments. This paper aims to show how to measure efficiency by eliminating waste in AEH system, identify service failure points, identify benchmark medical services, identify patient throughput time and measure treatment time when AEH services are nonstandard. The applications shown in this paper are distinct in particular; we the authors use nontraditional and systems engineering approach to collect data as the traditional data collection is difficult in real-time AEHs.

The authors show in this study how to measure overall patient treatment time from admission to discharge. Project evaluation and review technique (PERT) captures the inconsistencies involved in measuring treatment time, including measures of variability. The irregular treatment time and complexity involved in the emergency health-care services are usual. The research methodology illustrates how the time function map and service blueprint can improve value-added time in AEHs and benchmark services between similar AEHs.

The inconsistency in treatment time between AEH in public and private hospital is found to be in ratio of 1:20. The private hospital suggests variety of treatments and long stays for recovery. The PERT computations show that the average time a patient remains in a government AEH is about 10 days. The standard deviation of the AEH treatment time is about 0.043 per cent of the expected patient care time. The inconsistency is not significant as compared to the expected value. In 89.64 per cent of the cases, a patient may be discharged in less than 10 days’ time. The patient on average is discharged in 13 days in a private hospital.

The patient treatment time of an AEH is evaluated with PERT project management approach to account for inconsistencies in treatment time. This research makes new contributions in benchmarking AEH throughput time, identify medical service failure points with service blueprint, measure the efficiency with time function map and collect patient data with nontraditional methods. The inherent inconsistencies in a clinical process are identified by PERT analysis with the variance as a characteristic of the treatment time. Improvement of variability implies cost reduction in AEH system.

The purpose of this paper is to develop a multi-agent-based simulation model for the online opinion dissemination during hazardous chemical leakage emergencies into rivers in China, to explore an appropriate crisis information release policy of China’s government for controlling public panic.

In the proposed model, two fundamental attributes of crisis information, i.e., truthfulness (for true or false news) and attitude (for positive, neutral or negative opinion), are considered. Four major agents in the online community system, i.e., citizens, the government, media and opinion leaders, are included. Using four typical accidents of hazardous chemical leakage into rivers in China as case studies, insightful policy implications can be obtained for crisis management and panic control.

The news about the terrible potential damages from such a type of accidents will instantly arise wide-ranging public panic; therefore, the corresponding crisis information release policy should be carefully designed. It is strongly advised against publishing false news to temporarily conceal the accidents, which will seriously hurt the government’s reputation and agitate much larger-scale public panic in terms of degree and duration. To mitigate public panic, the true news especially about treatment measurements should be published immediately. If the government does nothing and releases no crisis information, the public panic will go out of control.

This paper only focuses on the crisis information release policies from the perspectives of the government. Furthermore, this study especially focuses on the cases in China, and extending the proposed model study for general contexts is an important direction to improve this study. Finally, the proposed model should be extended to other types of emergencies to further justify its generalization and universality, especially various natural catastrophes like storms, floods, tsunamis, etc.

This paper develops a multi-agent-based model for online public opinion dissemination in emergency to explore an appropriate crisis information release policy for controlling public panic stemming from hazardous chemicals leakage accidents into rivers. The proposed model makes major contributions to the literature from two perspectives. First, the crisis information about emergency accidents are divided into true and false news based on the truthfulness attribute, and into neutral, positive and negative emotions based on the attitude attribute. Second, the proposed model covers the main agents in the online virtual community.

The purpose of this paper is to develop, validate, and use a survey instrument to measure and compare the perceived quality of three types of US urgent care (UC) service providers: hospital emergency rooms, urgent care centres (UCC), and primary care physician offices.

This study develops, validates, and uses a survey instrument to measure/compare differences in perceived service quality among three types of UC service providers. Six dimensions measured the components of service quality: tangibles, professionalism, interaction, accessibility, efficiency, and technical quality.

Primary care physicians’ offices scored higher for service quality and perceived value, followed by UCC. Hospital emergency rooms scored lower in both quality and perceived value. No significant difference was identified between UCC and primary care physicians across all the perspectives, except for interactions.

The homogenous nature of the sample population (college students), and the fact that the respondents were recruited from a single university limits the generalizability of the findings.

The patient’s choice of a health care provider influences not only the continuity of the care that he or she receives, but compliance with a medical regime, and the evolution of the health care landscape.

This work contributes to the understanding of how to provide cost effective and efficient UC services.

This study developed and validated a survey instrument to measure/compare six dimensions of service quality for three types of UC service providers. The authors provide valuable data for UC service providers seeking to improve patient perceptions of service quality.

Globally, the presence of non-urgent patients in emergency departments (EDs) is considered one of the main reasons for creating excessive waiting times and overcrowding in units. This paper aims to understand the impact of non-urgent patients in EDs' operations.

This study is based on qualitative case studies conducted within two Brazilian EDs, and uses interviews and observations to access the data.

From a thematic analysis, three key themes emerged: characteristics of non-urgent demands in EDs, negative aspects of non-urgent patients in EDs, and the impact of the healthcare system model on EDs. These themes bring to light the impact that non-urgent patients have in EDs' operations, and provide theoretical and practical implications.

The limitation of this work is bound by the understanding of the non-urgent demands in EDs. Therefore, a benchmarking approach (investigating state-of-the-art practices to avoid such impact) was not applied but was suggested for future research instead.

The research provides significant contributions to practitioners and policymakers, aiding future discussions to improve healthcare coverage and performance.

The research provides significant contributions for managers and policymakers, aiding future discussions to improve healthcare. For instance, the use of well-known techniques (e.g. lean, six sigma) are discussed and suggested to enhance healthcare capacity and performance. Furthermore, the policymakers are called upon to evaluate the healthcare access and provide regulations that involve innovative approaches to widen healthcare access.

Based upon empirical data, this research extends the discussions related to non-urgent patient in EDs and is not limited merely to descriptive analysis, but by providing practical propositions and discussions related to the impact of these patients' presence in EDs' operations. Finally, the research provides a range of suggestions for future research related to the EDs' operational performance.

This article addresses issues of calculation and economization in contemporary public organizations. In particular, it investigates how choices of organizing emergency health-care have been affected by accounting as a performative device. Special attention has been paid to how accounting brings about performative consequences in shaping the medical profession and its context.

The article employs qualitative research methods and draws its analysis on empirical data from in-depth interviews at an emergency health-care unit in Sweden.

It is demonstrated how accounting, in the form of calculations of treatment time and number of patients, enables performative consequences for medical professional work. It is also demonstrated how the use of accounting engages (re)descriptions of practices and roles, creates accounts of patients, and helps to sustain such (re)descriptions. Accounting terms (such as efficiency and control) have been reframed into medical terminology (such as health-care quality and security), ensuring and retaining (re)described medical professional work in terms of practices and emerging roles.

This article contributes to (1) the literature on accounting practices within health-care contexts by demonstrating a case where the accounting ideas and practices of medical professionals are coexistent and interwoven and (2) the increasing body of literature focusing on accountingization by showing how emerging calculative technologies carry performative power over medical professional work through formative (re)descriptions.

The purpose of this paper is to report on the development of a qualitative systems model developed to understand why average emergency department (ED) length of stay (LOS) was rapidly increasing while the number of ED visits was relatively constant. The paper's focus was to identify systemic causes for poor patient flow so that the model could then be used to evaluate improvement options using a more complete view of the causal structure for the ED delays.

In this case study, a disciplined system dynamics approach was used that included development of a dynamic hypothesis, causal loop and stock and flow diagramming, interviews with system experts, and data collection and analysis.

Results support the dynamic hypothesis that an aging population and shortages of resources to treat chronically ill patients (among other dynamics) were causing longer average LOS. Older and sicker patients were consuming more ED resources and causing less acute patients to leave without being seen or to avoid visiting the ED in the first place. In essence, the ED was acting as a safety valve for the wider health care system as many parts of this wider system became overloaded.

Owing to the systemic causes for the patient treatment delay problem in the ED, simple local solutions are unlikely to be effective. The system model can be used as a basis to understand the underlying dynamics of the systemic causes for poor patient flow and identify robust and long‐term solutions.

The paper presents a process for developing a dynamic model to engage the various participants in a health care system in understanding the causes for delays and poor patient flow. The modeling approach can be used as a means for health care managers/administrators to identify improvement options that address the systemic problems.

Surgical treatment can be planned well in advance or arrive in a near emergency. If careful control is not exercised there is always the possibility that patients may suffer as a result. Discrete event simulation is an effective tool which can be used to find the most efficient ways of managing such a service’s timetable. Examines the application of a desktop computer simulation package to model the work of a cardiac diagnosis and treatment system. The simulation package suggests how efficiency might be improved by moderating times taken to complete activities and staff and other resources required to perform the activities. Suggests the principles outlined can be readily expanded into a more complex model.

The purpose of this paper is to analyze two process standardization theoretical conceptual constructs: process variants unification; and distinction between standard, routine and non-routine processes.

The authors analyze two conceptual constructs based on a single case study representing a general hospital’s (GH) process standardization, approach and results. The authors research whether process standardization implemented in a GH conforms to the process variants unification concept approach and its assumed benefits and whether implemented process standardization enables process management improvement based on distinguishing standard, routine and non-routine processes.

In accordance with the process variants unification conceptual construct, the hospital task force determined a uniform basic patient comprehensive treatment process at the hospital level, which allows synergy among departments. Uniform process activities reflect the differences between standard, routine and non-routine processes.

Process standardization through unification improves performance by establishing a common framework enabling shared experience based on improved process understanding. Distinguishing standard, routine and non-routine processes is useful for analyzing process management. This distinction provides guidelines for process implementation and measurement improvement. The paper also shows that increased routinization and standardization represent levers for process improvement.

The authors analyze theoretical constructs based on a single case study and confirm that theoretical conceptual construct application can provide better process management, which is important for practitioners.

Healthcare is indispensable for any civilisation to attain a good quality of life and well-being on both mental and physical levels. The healthcare domain primarily falls under pharma, medical, biotechnology, and nursing. Also, other fields may be aligned with these primary fields. Healthcare amasses the contemporary trends and knowledge of upcoming techniques to improve healthcare processes. The practitioners are primarily doctors, nurses, specialists and health professionals, hospital administrators, and health insurance.

It is a fundamental attribute needed for any society to attain good quality of life and well-being in mental and physical health. It is a fundamental right of people to receive good healthcare where drug treatment and hospitalization are available at a nominal cost, as a requirement of today’s modern era. There appears to be a significant disparity in the availability of good healthcare in rural areas compared to urban in India. Even though we enter the digital era with the facilities offered in Industry 4.0 and other advanced technologies brings about a significant change of overall processing within healthcare systems. During the pandemic of COVID-19, there has been digital transformation with success globally. Healthcare cooperatives are a new norm to support the healthcare systems globally. The chapter discusses Gampaha healthcare cooperative and reviews Ayushman Sahakar scheme in India. The reforms require time to evolve.