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Heating, ventilating, air-conditioning and cooling (HVAC) systems are crucial in daily health-care facility services. Design-related defects can lead to maintenance issues, causing service disruptions and cost overruns. These defects can be avoided if a link between the early design stages and maintenance feedback is established. This study aims to use experts’ experience in HVAC maintenance in health-care facilities to list and evaluate the risk of each maintenance issue caused by a design defect, supported by the literature.

Following semistructured interviews with experts, 41 maintenance issues were identified as the most encountered issues. Subsequently, a survey was conducted in which 44 participants evaluated the probability and impact of each design-caused issue.

Chillers were identified as the HVAC components most prone to design defects and cost impact. However, air distribution ducts and air handling units are the most critical HVAC components for maintaining healthy conditions inside health-care facilities.

The unavailability of comprehensive data on the cost impacts of all design-related defects from multiple health-care facilities limits the ability of HVAC designers to furnish case studies and quantitative approaches.

This study helps HVAC designers acquire prior knowledge of decisions that may have led to unnecessary and avoidable maintenance. These design-related maintenance issues may cause unfavorable health and cost consequences.

The integration of industry 4.0 has become a priority for many organizations. However, not all organizations are suitable and capable of implementing industry 4.0 because it requires a dynamic and flexible implementation strategy. The implementation of industry 4.0 often involves overcoming several tensions between internal and external stakeholders. This paper aims to explore the paradoxical tensions that arise for health-care organizations when integrating industry 4.0. Moreover, it discusses how a paradox lens can support the conceptualization and proposes techniques for handling tensions during the integration of industry 4.0.

This qualitative and in-depth study draws upon 32 semi-structured interviews. The empirical case concerns how two health-care organizations handle paradoxical tensions during the integration of industry 4.0.

The exploration resulted in six recurring technology tensions: technology invention (modularized design vs. flexible design), technology collaboration (automation vs. human augmentation), technology-driven patient experience (control vs. autonomy), technology uncertainty (short-term experimentation vs. long-term planning), technology invention and diffusion through collaborative efforts among stakeholders (selective vs. intensive collaboration) and technological innovation (market maintenance vs. disruption).

A paradox theory-informed conceptual model is proposed for how to handle tensions during the integration of industry 4.0. To the best of the authors’ knowledge, this is the first paper to introduce paradox theory for quality management, including lean and Six Sigma.

This study aims to deepen the understanding of the challenges and implications entailed by deploying mobile clinics in conflict zones to reach populations affected by violence and cut off from health-care services.

This research combines an integrated literature review and an instrumental case study. The literature review comprises two targeted reviews to provide insights: one on conflict zones and one on mobile clinics. The case study describes the process and challenges faced throughout a mobile clinic deployment during and after the Iraq War. The data was gathered using mixed methods over a two-year period (2017–2018).

Armed conflicts directly impact the populations’ health and access to health care. Mobile clinic deployments are often used and recommended to provide health-care access to vulnerable populations cut off from health-care services. However, there is a dearth of peer-reviewed literature documenting decision support tools for mobile clinic deployments.

This study highlights the gaps in the literature and provides direction for future research to support the development of valuable insights and decision support tools for practitioners.

Value-based health care (VBHC) argues that health-care needs to re-focus to maximise value creation, defining value as the quota when dividing the outcomes important for the patient, by the cost for health care to deliver such outcomes. This study aims to explore the perception of value among different stakeholders involved in the process of implementing VBHC at a Swedish hospital to support leaders to be more efficient and effective when developing health care.

Participants comprised 19 clinicians and non-clinicians involved in the implementation of VBHC. Semi-structured interviews were conducted and content analysis was performed.

The clinicians described value as a dynamic concept, dependent on the patient and the clinical setting, stating that improving outcomes was more important than containing costs. The value for non-clinicians appeared more driven by the interplay between the outcome and the cost. Non-clinicians related VBHC to a strategic framework for governance or for monitoring different continuous improvement processes, while clinicians appreciated VBHC, as they perceived its introduction as an opportunity to focus more on outcomes for patients and less on cost containment.

There is variation in how clinicians and non-clinicians perceive the key concept of value when implementing VBHC. Clinicians focus on increasing treatment efficacy and improving medical outcomes but have a limited focus on cost and what patients consider most valuable. If the concept of value is defined primarily by clinicians’ own assumptions, there is a clear risk that the foundational premise of VBHC, to understand what outcomes patients value in their specific situation in relation to the cost to produce such outcome, will fail. Health-care leaders need to ensure that patients and the non-clinicians’ perception of value, is integrated with the clinical perception, if VBHC is to deliver on its promise.

In this viewpoint article, the authors recognize the increased focus in health systems on co-design for innovation and change. This article explores the role of leaders and mangers in developing and enhancing a culture of trust in their organizations to enable co-design, with the potential to drive innovation and change in healthcare.

Using social science analyses, the authors argue that current co-design literature has limited focus on interactions between senior leaders and managers, and healthcare staff and service users in supporting co-designed innovation and change. The authors draw on social and health science studies of trust to highlight how the value-based co-design process needs to be supported and enhanced. We outline what co-design innovation and change involve in a health system, conceptualize trust and reflect on its importance within the health system, and finally note the role of senior leaders and managers in supporting trust and responsiveness for co-designed innovation and change.

Healthcare needs leaders and managers to embrace co-design that drives innovation now and in the future through people – leading to better healthcare for society at large. As authors we argue that it is now the time to shift our focus on the role of senior managers and leaders to embed co-design into health and social care structures, through creating and nurturing a culture of trust.

Building public trust in the health system and interpersonal trust within the health system is an ongoing process that relies upon personal behavior of managers and senior leaders, organizational practices within the system, as well as political processes that underpin these practices. By implementing managerial, leadership and individual practices on all levels, senior managers and leaders provide a mechanism to increase both trust and responsiveness for co-design that supports innovation and change in the health system.

This paper aims to review research on mental health and well-being (MHW) in tourism, which the United Nations addresses in Sustainable Development Goal No. 3 (SDG 3). The authors also pinpoint future directions regarding how tourism can contribute to this goal from theoretical and practical standpoints.

The authors review the literature on MHW in tourism from the perspectives of tourists, residents and tourism workers.

Researchers have predominantly analysed tourists’ MHW outcomes through the lenses of positive psychology and tourism therapy; only a small number of studies have focused on MHW-related benefits and challenges in terms of tourism development for residents and tourism workers. Investigations of MHW in tourism require interdisciplinary approaches to reveal how tourism promotes diverse stakeholders’ mental health. Practically, there is an urgent need to incorporate tourism products and services into mental health care, and design tourism experience with positive psychology principles.

This study offers insights into fostering MHW through tourism. It specifically proposes theoretical and practical ways in which tourism might enhance MHW for various industry stakeholders, contributing to SDG 3.

本文基于联合国可持续发展目标中的第三个目标（SDG 3）, 对旅游中的心理健康和幸福感研究进行了回顾, 并就旅游如何助推这一目标的实现指明了未来的研究和实践方向。

本文从游客、居民和旅游从业者的角度对与旅游中的心理健康和幸福感相关的文献进行了回顾和评估。

当前研究主要从积极心理学和旅游疗法的视角分析了游客的心理健康和幸福感, 有关旅游业发展对居民和旅游从业者心理健康和幸福感的积极影响及挑战的研究尚不多见。因此, 需采用跨学科进路来揭示旅游业对不同利益相关者心理健康的促进作用。在实践方面, 亟需将旅游产品和服务纳入到心理健康护理体系中, 并依据积极心理学原理来开展旅游体验设计。

本文为通过旅游发展来促进心理健康与幸福感这一主题提供了见解。本文为旅游业如何提高各利益相关者的心理健康与幸福感提供了理论方面和实践方面的进路, 从而助推联合国可持续发展目标中第三个目标的实现。

Este artículo revisa los estudios y las investigaciones sobre la salud mental y el bienestar en el turismo (MHW por sus siglas en inglés, basándose en el Objetivo de Desarrollo Sostenible 3 (ODS 3) de las Naciones Unidas, y explora las futuras direcciones de investigación y práctica en el impulso del logro de este objetivo a través del turismo.

Se revisa la literatura relevante sobre la salud mental y el bienestar en el turismo desde la perspectiva de los turistas, residentes y trabajadores del sector turístico.

Actualmente, las investigaciones se centran principalmente en el análisis de la salud mental y el bienestar de los turistas desde la perspectiva de la psicología positiva y la terapia de turismo. Sin embargo, hay una falta de investigación sobre el impacto positivo y los desafíos del desarrollo turístico en la salud mental y el bienestar de los residentes y trabajadores del turismo. Por lo tanto, se requiere un enfoque interdisciplinario para revelar el papel del turismo en la promoción de la salud mental para diferentes partes interesadas. En cuanto a la práctica, se debe explorar activamente la integración de productos y servicios turísticos en el cuidado de la salud mental y diseñar actividades turísticas basadas en los principios de la psicología positiva.

Este estudio ofrece perspectivas sobre el papel del turismo en la promoción de la salud mental y el bienestar. Al proponer rutas teóricas y prácticas para mejorar la salud mental y el bienestar de las partes interesadas en el turismo, este artículo tiene como objetivo contribuir al logro del Objetivo de Desarrollo Sostenible 3 (ODS 3) de las Naciones Unidas.

The study aims to explore how including biophilic elements in the architectural and interior design of assisted living facilities can improve the well-being and quality of life of older people. This research paper explores the concept of biophilic design and its potential benefits for assisted living facilities.

A total of 39 peer-reviewed articles were reviewed. The research involved a comprehensive review of databases such as Scopus, EBSCO, Elsevier, JSTOR and Google Scholar using keywords and Boolean operators with reference to the study. The study’s inclusion criteria for articles were restricted to academic articles published between 2013 and 2022. The analysis of the current research will offer insights into the concept of biophilic design research and its impact on the well-being and quality of life of baby boomers in assisted living facilities.

The research advocates the benefits of biophilic design to enhance the psychological well-being and quality of life of baby boomers dwelling in assisted living facilities. Biophilic design is a strategy that blends natural elements into built environments to improve our connection with nature to enhance the physical and psychological health of older people. In the context of assisted living facilities, where residents commonly experience a variety of physical and psychological health concerns, adopting biophilic design in architecture holds enormous promise.

The research focuses on applying biophilic design in assisted living facilities and its holistic approach to the overall well-being of older people. The conceptual model proposed in the study has defined the positive aspects of the biophilic design on the psychological and physiological health of older people. Few studies have been done on the impact of biophilic design, specifically on baby boomers.

The purpose of this investigation is to scrutinize the unexplored realm concerning the interplay of hospital brand gestalt on patient satisfaction and revisit intentions.

A self-administered online survey was conducted with 227 patients who had stayed at and received health-care services from a private hospital in the city of Manado, Indonesia, within the past 12 months. The quantitative data were subsequently analyzed using a structural equation model with the assistance of Smart PLS statistical software.

The results suggest that the hospital brand gestalt significantly and positively influences patient satisfaction, which, in turn, leads to patients’ intentions to revisit. Furthermore, patient satisfaction serves as a significant mediator in the relationship between brand gestalt and revisit intentions.

This study enhances the comprehension of brand gestalt’s influence on customer attitudes and behaviors within the health-care context, contributing to the expanding body of literature concerning holistic brand perception. For health-care providers, the study underscores the significance of creating a uniform and distinctive brand experience to boost patient satisfaction and cultivate loyalty. In summary, this study paves the way for strategic branding initiatives in health care, ultimately enhancing patient experiences and organizational outcomes.

For health-care providers, this study emphasizes the importance of crafting a consistent and differentiated brand experience to enhance patient satisfaction and foster loyalty. Overall, this study opens avenues for strategic branding efforts in health care, ultimately improving patient experiences and organizational outcomes.

While there is a growing interest in the role of brand gestalt in marketing research, there is still a need for more empirical research to explore the link between brand gestalt, customer satisfaction and revisit intention. Surprisingly, to the best of the authors’ knowledge, no previous studies have investigated the role of brand gestalt in the context of health care.

A large number of studies indicate that coercive forms of organizational control and performance management in health care services often backfire and initiate dysfunctional consequences. The purpose of this article is to discuss new approaches to performance management in health care services when the purpose is to support innovative changes in the delivery of services.

The article represents cross-boundary work as the theoretical and empirical material used to discuss and reconsider performance management comes from several relevant research disciplines, including systematic reviews of audit and feedback interventions in health care and extant theories of human motivation and organizational control.

An enabling approach to performance management in health care services can potentially contribute to innovative changes. Key design elements to operationalize such an approach are a formative and learning-oriented use of performance measures, an appeal to self- and social-approval mechanisms when providing feedback and support for local goals and action plans that fit specific conditions and challenges.

The article suggests how to operationalize an enabling approach to performance management in health care services. The framework is consistent with new governance and managerial approaches emerging in public sector organizations more generally, supporting a higher degree of professional autonomy and the use of nonfinancial incentives.

Health care systems aspire to adopt integration strategies shifting the focus from acute care to a broader focus on community-based health and social services. Real-world examples demonstrating effective delivery of integrated care are essential.

In this article, we introduce UHN Connected Care Hub, an innovative model of care comprising an interdisciplinary team designing sustainable, shareable practices across the continuum of care alongside community and health organization partnerships.

We describe UHN Connected Care Hub’s ability to identify patients from high-risk population and collaborate to delivery timely care, in detailing the real world experience of this model of care in the organization of a centralized system of micro-clinics to administer a therapeutic for pre-exposure prophylaxis against COVID-19 (Tixagevimab/cilgavimab [Evusheld]) in a population of immunocompromised patients.

Having a centralized system of micro-clinics for care delivery presents opportunities for increased adaptability, patient accessibility, enhanced community partnerships and integratedness. Expansion in the scope of services could also create new opportunities in preventative therapies for optimizing the cost effectiveness and quality of health care provided at the population level.

There is limited evidence on how to efficiently deliver integrated care, particularly to vulnerable and co-morbid patients. We discuss how dynamic organizations with proper infrastructure and a network of healthcare partnerships may allow a more fluid response to rapidly changing policies and procedures and facilitate preparedness for future health care crises or pandemics.