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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.

The increasing financial burden and complexity of health-care services, exacerbated by factors such as an ageing population and the rise of chronic conditions, necessitate comprehensive and integrated care approaches. While co-created service design has proven valuable in transforming some service industries, its application to the health-care industry is not well understood. This study aims to examine how health consumers are involved in health-care service co-creation.

The study searched 11 electronic databases for peer-reviewed articles published between 2010 and 2019. Additionally, hand searches of reference lists from included studies, Google^© citation searches and searches for grey literature were conducted. The Whittemore and Knafl integrative framework guided the systematic review, and Callahan’s 6 Ws framework was used to extract data from the included articles, facilitating comparisons.

The authors identified 21 articles, mainly from the UK, North America and Australia. Despite the need for more research, findings reveal limited and geographically narrow empirical studies with restricted theory and method applications. From these findings, the authors constructed a conceptual model to enhance nuanced understanding.

This study offers four contributions. First, it introduces the Health Service Design Transformation Model for Comprehensive Consumer Co-Creation, illustrating health consumers’ multifaceted roles in shaping services. Second, consumer vulnerabilities in co-creating services are identified, linked to diverse consumer groups, power dynamics and decision complexity. Third, this study suggests broadening participant inclusion may enhance consumer-centricity, inclusivity and innovation in service design. Finally, the research agenda explores consumer experiences, organizational dynamics, value outcomes and co-creation theory for health-care service advancement.

This paper aims to examine the influence of procurement physiognomies on the creative accounting (CA) of listed health-care firms in Nigeria from 2016 to 2020.

This paper used positivist paradigm. Annual reports and accounts, questionnaire and e-mails were used to obtained and extract quantitative data. The data were analyzed using OLS regression.

The study found that, procurement planning, e-procurement and procurement legislation compliance possessed negative weighty consequence on CA of quoted Nigerian health-care corporations while outsourcing, procurement staff competency and strategic supplier partnership possess positive substantial impact on the firms’ CA. The article concluded that procurement physiognomies play an important role in managing CA of health-care firms.

This study findings are only applicable to listed health-care firms in Nigeria. It only used six procurement attributes. The research implication is that researchers are to use the findings in conducting further studies on procurement physiognomies and CA to help in coming up with ways of curbing irregularities in the organizations.

The health-care firms are to use the findings to come up with policies that ensure malpractices in procurement are curbed and CA is minimized to its barest level. Its societal implication is that the public is to use the findings in changing societal attitudes toward earnings manipulation.

Its societal implication is that the public is to use the findings in changing societal attitudes toward earnings manipulation.

To the best of the authors’ knowledge, this article is the first to evaluate the influence of procurement physiognomies on CA in Nigerian-listed health-care companies. Many researchers neglect how procurement is used to carry out a lot of CA and this study focuses on a mechanism for curtailing corruption.

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.

The Purpose of the study was to investigate the construct validity and internal consistency of the LaMI among staff in the context of elderly care in Sweden.

Questionnaire data from a longitudinal study of staff working in elderly care were used. Data were collected using the Leadership and Management Inventory. First data collection was for explorative factor analysis (n = 1,149), and the second collection, one year later, was for confirmatory factor analysis (n = 1,061).

The explorative factor analysis resulted in a two-factor solution that explained 70.2% of the total variance. Different models were tested in the confirmatory factor analysis. The final model, a two-factor solution where three items were omitted, showed acceptable results.

The instrument measures both leadership and management performance and can be used to continually measure managers’ performances as perceived by staff to identify areas for development.

Designing and developing safe systems has been a persistent challenge in health care, and in surgical settings in particular. In efforts to promote safety, safety culture, i.e., shared values regarding safety management, is considered a key driver of high-quality, safe healthcare delivery. However, changing organizational culture so that it emphasizes and promotes safety is often an elusive goal. The Safe Surgery Checklist is an innovative tool for improving safety culture and surgical care safety, but evidence about Safe Surgery Checklist effectiveness is mixed. We examined the relationship between changes in management practices and changes in perceived safety culture during implementation of safe surgery checklists. Using a pre-posttest design and survey methods, we evaluated Safe Surgery Checklist implementation in a national sample of 42 general acute care hospitals in a leading hospital network. We measured perceived management practices among managers (n = 99) using the World Management Survey. We measured perceived preoperative safety and safety culture among clinical operating room personnel (N = 2,380 (2016); N = 1,433 (2017)) using the Safe Surgical Practice Survey. We collected data in two consecutive years. Multivariable linear regression analysis demonstrated a significant relationship between changes in management practices and overall safety culture and perceived teamwork following Safe Surgery Checklist implementation.

The paper aims to examine the association of green human resource management (GHRM) with organisational sustainability (OS) through the mediating function of corporate social responsibility (CSR) and organisational citizenship behaviour for the environment (OCBE) in Palestinian health-care organisations.

The paper applied a quantitative method in which data are collected from a survey with 88 human resources and quality managers who work in Palestinian health-care organisations. Furthermore, the structural equation modelling method of partial least squares was used for the data analysis.

The results demonstrated that GHRM practices positively influenced CSR and OCBE, which eventually influenced OS. Notably, this study offers empirical insights into how to improve OS through CSR, OCBE and GHRM approaches.

This paper presents the implications for achieving the health care sector’s long-term sustainability by linking strategic environmental goals of human resources management practices with practices of social responsibility and organisational citizenship behaviour, which ensures employee participation in formulating policies and strategies for the organization.

The purpose of this study is to determine the interactions between factors such as organizational learning, feedback about errors, punitive response to errors and communication quality in hospitals in the Kingdom of Saudi Arabia and Colombia when adopting a culture of quality and safety (CQS) in patient care.

Based on a literature review, a self-administered questionnaire was developed and used to collect data from 417 Saudi respondents affiliated with hospitals and 483 Colombian respondents at the beginning of the pandemic. Structural equation modeling is used in this study to test the hypothesized relationships.

The results show a solid and significant predictive relationship between feedback about errors and the CQS in both countries (Colombia: b = 0.55, p < 0.001; KSA: b = 0.44, p < 0.001), but a very low and insignificant predictive relationship between no punitive response to errors and CQS (Colombia: b = –0.02, p > 0.05; KSA: b = 0.05, p > 0.05).

This study demonstrates the importance of organizational learning in fostering a CQS in the health-care sector in the Kingdom of Saudi Arabia and Colombia. Recent unprecedented policy actions motivated by the COVID-19 pandemic, such as social distancing, lockdowns and safety practices enforcement, have further highlighted this concern. Moreover, attention to the dimensions addressed in this study is required for accreditation purposes in organizations seeking to promote a CQS. Overall, this research highlights the vital role of safety and quality practices among health-care organizations, which has significant policy implications, especially in the current period of high uncertainty.

This paper contributes to the theory and practice in the health-care sector by extending the current knowledge of the impact of the quality of communications, non-punitive response to errors and feedback about errors in organizational learning and safety culture, and by presenting a novel, quantitative methodology seldom used for these topics.

The purpose of this review paper was identifying barriers to the use of telemedicine systems in primary health-care individual level among professionals.

This study used Scopus and PubMed databases for scientific records identification. A systematic review of the literature structured by PRISMA guidelines was conducted on 37 included papers published between 2009 and 2019. A qualitative approach was used to synthesize insights into using telemedicine by primary care professionals.

Three barriers were identified and classified: system quality, data quality and service quality barriers. System complexity in terms of usability, system unreliability, security and privacy concerns, lack of integration and inflexibility of systems-in-use are related to system quality. Data quality barriers are data inaccuracy, data timeliness issues, data conciseness concerns and lack of data uniqueness. Finally, service reliability concerns, lack of technical support and lack of user training have been categorized as service quality barriers.

This review identified and mapped emerging themes of barriers to the use of telemedicine systems. This paper also through a new conceptualization of telemedicine use from perspectives of the primary care professionals contributes to informatics literature and system usage practices.

This paper aims to discover and analyze the challenges hampering blockchain technology’s (BT’s) implementation in the Indian health-care sector. A total of 18 challenges have been prioritized and modeled based on an extensive literature search and professional views.

An integrated multi-criteria decision-making approach has been used in two phases. Best worst method (BWM) is used in the first phase to prioritize the challenges with sensitivity analysis to validate the findings and eliminate a few challenges. In the second phase, interpretive structural modeling is applied to the remaining 15 challenges to obtain relative relationships among them with cross-impact matrix multiplication applied to classification analysis for their categorization.

The study’s results reveal that limited knowledge and expertise, cost and risk involved, technical issues, lack of clear regulations, resistance to change and lack of top management support are the top-ranked or high-intensity challenges according to the BWM. Interpretive structural modelling findings suggest that the lack of government initiatives has been driving other challenges with the highest driving power.

This work has been conducted in the Indian context, so careful generalization of the results is needed.

This work will give health-care stakeholders a better perspective regarding blockchain’s adoption. It will help health-care stakeholders, service providers, researchers and policymakers get a glimpse of the strategies for eradicating mentioned challenges. The analysis will help reduce the challenges’ impact on blockchain’s adoption in the Indian health-care sector.

The adoption of BT is a novel concept, especially in developing countries such as India. This is one of the few works addressing the challenges to BT adoption in the Indian health-care sector.