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This paper describes a modelling process the objective of which was to make the highly abstract concept of core competence practical. The aim is to identify competences through the use of a service-process model by analyzing what they reflect – the service quality. Core competence is defined, and a conceptual model is presented. Competences are classified on three levels in a corporate setting and the connections drawn to service quality. Empirical evidence is provided by a case in the health-care sector in which competences are identified through the use of the service-process model in high-performance, professional services. The service-process model in surgical medical services is presented. Critical elements in the service-quality experience are identified and core competences are identified based on service quality as a reflection of them and their management.

With an aim to investigate the recent state of the feminist clinics and their negotiation of medical authority in a time of increased technoscientific biomedicalization, and capitalistic health-care system, I conducted a study of two feminist health centers in the Northeast of the United States in 2001–2002. In this chapter, I discuss how the two centers (a nonprofit collective and a for-profit center with a more hierarchical structure) negotiated medical authority in organizational terms as impacted by the larger context of medicine and its interaction with the state, capitalist health-care system, and antiabortion forces. The chapter concludes with a discussion of demedicalization as a multilevel process and implications for feminist care (service delivery) and U.S. Women's Health Movement.

The dynamics of the physician knowledge system in the Southern California Region of Kaiser Permanente are explored. The framing and analysis use concepts from the knowledge management literature and network theory. The criticality of this issue to the establishment of sustainable healthcare relates to the lynchpin nature of embedding evidence-based knowledge in healthcare practice and the simultaneous challenge of combining this with clinical knowledge that derives from practice.

The case study is compiled from longitudinal interviews with over 40 physicians and other stakeholders and an examination of archival information including published articles generated by the learning system.

The socio-technical approach to building this learning system was critical given the expectations of physicians for autonomy in making clinical decisions with respect to their patients. This robust learning system builds on rich professional and organizational networks, is led by physicians, and builds on and extends the foundation of evidence relating to quality and value. The goals of the physician practice and a robust measurement and feedback system provide focus for the learning system.

Accelerating the incorporation of evidence-based practice and increasing the scope and reach of the learning system entails building physician networks, having a robust system for critically examining and extending evidence, and a clear linkage to valued outcomes.

This detailed examination of the dynamics of knowledge absorption extends understanding of the capacity of medical care systems to absorb evidence-based knowledge.

Although it is widely acknowledged that health care delivery systems are complex adaptive systems, there are gaps in understanding the application of systems engineering approaches to systems analysis and redesign in the health care domain. Commonly employed methods, such as statistical analysis of risk factors and outcomes, are simply not adequate to robustly characterize all system requirements and facilitate reliable design of complex care delivery systems. This is especially apparent in institutional-level systems, such as patient safety programs that must mitigate the risk of infections and other complications that can occur in virtually any setting providing direct and indirect patient care. The case example presented here illustrates the application of various system engineering methods to identify requirements and intervention candidates for a critical patient safety problem known as failure to rescue. Detailed descriptions of the analysis methods and their application are presented along with specific analysis artifacts related to the failure to rescue case study. Given the prevalence of complex systems in health care, this practical and effective approach provides an important example of how systems engineering methods can effectively address the shortcomings in current health care analysis and design, where complex systems are increasingly prevalent.

Medical errors in obstetric departments are commonly reported and may involve both mother and neonate. The complexity of obstetric care, the interactions between various disciplines, and the inherent limitations of human performance make it critically important for these departments to provide patient-safe and friendly working environments that are open to learning and participative safety. Obstetric care involves stressful work, and health care professionals are prone to develop burnout, this being associated with unsafe practices and lower probability for reporting safety concerns. This study aims to test the mediating role of burnout in the relationship of patient-safe and friendly working environment with unsafe performance. The full population of professionals working in an obstetrics department in Malta was invited to participate in a cross-sectional study, with 73.6% (n = 184) of its members responding. The research tool was adapted from the Sexton et al.’s Safety Attitudes Questionnaire – Labor and Delivery version and surveyed participants on their working environment, burnout, and perceived unsafe performance. Analysis was done using Structural Equation Modeling. Results supported the relationship between the lack of a perceived patient-safe and friendly working environment and unsafe performance that is mediated by burnout. Creating a working environment that ensures patient safety practices, that allows communication, and is open to learning may protect employees from burnout. In so doing, they are more likely to perceive that they are practicing safely. This study contributes to patient safety literature by relating working environment, burnout, and perceived unsafe practice with the intention of raising awareness of health managers’ roles in ensuring optimal clinical working environment for health care employees.

Customers today expect businesses to cater to their individual needs by tailoring the products they purchase to their own preferences. The term “Industry 5.0” refers to a new wave of manufacturing that aims to meet each customer's unique demands. Even while Industry 4.0 allowed for mass customization, that wasn't good enough before, customers today demand individualized products at scale, and Industry 5.0 is driving the transition from mass customization to mass personalization to meet these demands. It caters to the individual needs of each consumer by meeting their demands. More specialized components for use in medicine are made possible by the widespread customization made possible by Industry 5.0. These individualized parts are included into the medical care of the patient to meet their specific needs and preferences. In the current medical revolution, an enabling technology of Industry 5.0 can produce medical implants, artificial organs, bodily fluids, and transplants with pinpoint accuracy. With the advent of AI-enabled sensors, we now live in a world where data can be swiftly analyzed. Machines may be programmed to make complex choices on the fly. In the medical field, these innovations allow for exact measurement and monitoring of human body variables according to the individual's needs. They aid in monitoring the body's response to training for peak performance. It allows for the digital dissemination of accurate healthcare data networks. In order to collect and exchange relevant patient data, every equipment is online.

The crisis in the Niger Delta predates discovery of oil in large quantities at Oloibiri in 1956. Before independence in 1960, conflict in the region took the form of agitation for political representation and protection against marginalization by the dominant ethnic groups. However, this crisis took a new dimension in the early 1990s as oil became a major source of foreign exchange and the derivation formula was changed in favour of the federal government with negative consequences on the local people (the need to maintain constant flow of oil have resulted to gross violation of the local people's rights by the state and the oil multinationals) especially under the military regimes. The entrenchment of democracy in the late 1990s further escalated the tripartite conflict between the state, oil multinationals and host communities as the complex crisis drew global attention. The formation of Movement for the Survival of Ogoni People (MOSOP) and Ijaw Youth Council (IYC) in the 1990s to challenge the abuse of human rights over four decades was overwhelmed applauded by the local people of the region. More importantly, MOSOP was the first social movement in the region to have internationalized the plight of the local people while IYC took over from the period when MOSOP had some internal crises that undermined its struggle.

Equally the achievements of MOSOP and IYC have instigated the formation of other social movements in the Niger Delta as a whole. The pressure from these social movements might have accounted for sudden change of policies by the state and the major oil multinationals in the mid-1990s. However, the fundamental question is to what extent the social movements (MOSOP/IYC) and International civil society have been successful with the issue of human rights abuse in the region.

According to Global Healthcare Security Index 2021, India ranked 66 out of 195 countries, indicating the need and scope for improvement. The Cooperative healthcare system which has been rendering exemplary services is yet to gain visible recognition in India. Given the need for upgrading the health infrastructure in India and providing more affordable health services to the country’s growing population, it would help appreciate the large role that cooperative healthcare can play along with others. This study explores the structure, conduct, and performance of healthcare co-operatives in India, the factors contributing to their success and failure, and the challenges they face. The Health Cooperatives have a strong presence in Kerala and Karnataka and are also coming up in other parts of the country. However, a detailed database of them for public awareness is very limited. The cooperative hospitals can meet the basic requirements of curative treatment in rural and poorly-endowed urban areas. The democratic way in which they function makes them a destination for a financially weaker section. They must retain this feature. The study covers two successful cases which reveal that India needs a more dense healthcare cooperative network. Since cooperative hospitals in tune with the spirit of service run on the principle of being ‘Not-for-Profit’ they need to be supported by the governments more liberally, without however interfering with their governance and administration.

This edited collection proposes an interdisciplinary and integrated approach to the study of reproductive technologies (RTs), which reflects the fact that many people use different technologies throughout their lifecourse and resists the disciplinary siloing of research on these technologies. The ever-expanding availability of RTs, the continued roll-out of ‘family planning’ and maternity services across low- and middle-income settings and the rapid development of the fertility industry mean that it is more likely than ever that individuals, especially women and trans* people, will engage with more than one RT at some point in their life. These multiple engagements with RTs will affect users' expectations and uptake, as well as the technologies' availability, commercial success, ethical status and social meanings. We offer this book as part of a wider movement in the study of reproduction and RTs, which takes inspiration from the reproductive justice framework to address forms of exclusion, discrimination and stratification that are perpetuated in the development and application of RTs and the ways in which they are studied and theorised. Here, we introduce the project and outline the structure of the book.