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Quantifying the performance level of surgeons with digital virtual reality (VR) simulators can help ensure that quality requirements in healthcare are met. In order to better understand integration amongst quality principles, practices and technologies in the adoption and diffusion of VR simulators, the authors applied a technological innovation system (TIS) framework. The purpose of this study is to understand how the adoption and diffusion of VR surgical simulators in a Swedish healthcare context is influenced by various system factors.

In this study, single-case holistic design based on innovation system theory was used to analyse the adoption of digital quality technologies related to surgical performance in Swedish hospitals. The case employs a mixed methods approach triangulating data longitudinally from published documents and expert interviews.

Adoption of digital technologies regarding surgical performance is restricted by system factors relating to inconsistent normative and regulatory requirements for quantified performance criteria to judge surgical expertise. Addressing these systems' weaknesses with evidence-based training programmes can have a significant impact on the further development of the innovation system and can ultimately affect healthcare reliability and quality.

This paper explores quality management (QM) challenges in the context of digital transformation in healthcare. The paper attempts to fill the gap for TIS studies in a healthcare context and highlight the role of innovation function strength along the value chain and in relation to technology cycles to increase the understanding of adoption of digital technologies relating to surgical performance.

The purpose of this study is to estimate economies of scale in Turkish Ministry of Health hospitals. Turkey is in the process of changing their healthcare system. Estimating economies of scale for Turkish hospitals will help funding decisions as Turkey determines whether to build, expand, or consolidate hospitals. The structural changes currently taking place provide an opportunity to revamp the way healthcare is provided so that access to and efficiency within healthcare can be increased in a cost effective manner. Data are collected from the Ministry of Health. The results suggest there is an optimal size for Turkish hospitals. Also, this study shows that hospitals in certain regions of Turkey are more efficient than other regions. Determining the characteristics of efficient hospitals is important if Turkey is to properly allocate scarce healthcare funding.

The purpose of this paper is to suggest how decision-makers may work towards a broader perspective on value than that expressed in financial economics-based accounting terms to enhance value in healthcare.

The authors review published academic research and reports on practice across a range of disciplines.

The authors find that while value is a multidimensional concept, which is open to perceptions that differ across stakeholders in healthcare, financial economics-based accounting is essentially mono-disciplinary and dominates decisions. Enhancing value in health is a wicked problem, and a trans-disciplinary approach has the potential to enable decision-makers to enhance value.

The suggest that a trans-disciplinary approach, which dissolves disciplinary boundaries, is capable of enabling decision-makers to work towards understanding and enhancing value by fostering awareness of stakeholders' perceptions of value. A critical caveat is that a trans-disciplinary approach does not guarantee ready-made or immediate solutions; it does, however, offer the means to struggle towards a destination which may be continually shifting.

This study highlights the importance of a broader understanding of the concept of value than that implied by financial economics-based accounting and recognises the perceptions of stakeholders. It explores the inter-relationship among “the view from nowhere”, wicked problems and trans-disciplinarity and recommends a trans-disciplinary approach with a view to enhancing value in that broader sense. In this way, it contributes to the accounting literature, which has previously paid little attention to some of these aspects.

Understanding the outcomes of co-creation (CC) in healthcare is increasingly gaining multidisciplinary scientific interest. Although more and more service management scholars have pointed out the benefits of cross-fertilization between the various research fields, the literature on this topic is still scattered and poorly integrated. This study aims to summarize and integrate multiple strands of extant knowledge CC by identifying the outcomes of health CC and the determinants of these outcomes and their relationships.

A structured literature review was conducted per PRISMA guidelines. A total of 4,189 records were retrieved from the six databases; 1,983 articles were screened, with 161 included in the qualitative thematic analysis.

This study advances a comprehensive framework for healthcare CC based on a thorough analysis of the outcomes and their determinants, that is, antecedents, management activities and institutional context. Extant research rarely evaluates outcomes from a multidimensional and systemic perspective. Less attention has been paid to the relationship among the CC process elements.

This study offers an agenda to guide future studies on healthcare CC. Highlighting some areas of integration among different disciplines further advances service literature.

The framework offers an operational guide to better shape managerial endeavors to facilitate CC, provide direction and assess multiple outcomes.

This is the first extensive attempt to synthesize and integrate multidisciplinary knowledge on CC outcomes in healthcare settings by adopting a systematic perspective on the overall process.

This paper aims to provide a history of graduate healthcare management education in the USA with an emphasis on the comparison of business schools and health science settings. It seeks to explain why different organizational cultures exist and how this affects education.

The approach relies on literature review and descriptive analysis using secondary data. Institutional economics helps provide perspective on different academic cultures and orientations.

Healthcare management education originated in the early twentieth century. Business schools at the University of Chicago and Northwestern were early pioneers. By mid‐century, schools of public health and medicine entered and came to dominate with strong graduate programs at Berkeley, Michigan and other leading universities. More recently, business schools have differentiated away from the generic MBA and expanded into this market. Advocates of health science settings commonly see healthcare as different from other forms of management. The externally funded model of medical education relying on patient and grant revenues dominates the health sciences. This can lead to preference for faculty who generate funds and a neglect of core academic areas that historically have not relied on grants and contracts.

This history of health management education provides insight for students, researchers, educators and administrators. It underscores comparative advantage of different academic settings.

This paper serves to fill a gap in the management literature. It provides history and perspective about academic settings not readily available.

With high public debts and suffering economies after the COVID-19 pandemic, governments will look for ways to promote recovery. Literature substantially reports on the favorable macroeconomic impact of the healthcare sector.

The authors use data on 19 European countries. Over 30 variables are analyzed to find factors that foster or suppress the economic impact of the healthcare sector. The economic impact is thereby expressed through five types of total multipliers, acting as dependent variables. The authors estimate multiple econometric models.

The results indicate factors that intensify or reduce the economic impact of the healthcare sector as they cause the value of one or more economic multipliers to augment or to diminish. Positive effects are expected from the growth of public funds' share in total healthcare expenditure leading to a higher output, income and value-added multipliers. The import multiplier diminishes when expenditure on healthcare as percent of GDP rises. On the other hand, rising expenditure on pharmaceuticals in the share of healthcare expenditure lowers the output multiplier. Rising GDP per capita and higher healthcare systems' technical efficiency cause the employment multiplier to lower.

Policymakers can strengthen the economic impact of the healthcare sector on the national economy. This could be achieved by stimulating factors, being identified in our study. Strengthening the economic impact of the healthcare sector is especially welcomed when fostering economic recovery is needed.

The healthcare system in the USA is undergoing unprecedented change and its share of unintended consequences. This paper explores the leadership role of the physician in transforming the present culture of healthcare to restore, refine and preserve its traditional care components.

The literature on change, organizational culture and leadership is leveraged to describe the structural interdependencies and dynamic complexity of the present healthcare system and to suggest how physicians can strengthen the care components of the healthcare culture.

When an organization’s culture does not support internal integration and external adaptation, it is the responsibility of leadership to transform it. Leaders can influence culture to strengthen the care components of the healthcare system. The centrality of professionalism in the delivery of patient services places a moral, societal and ethical responsibility on physicians to lead a revitalization of the care culture.

This paper focuses on cultural issues in healthcare and provides options and guidance for physicians as they attempt to lead and manage the context in which services are delivered.

The Competing Values Framework, the major interdependent domains and five principal mechanisms for leaders to embed and fine tune culture serve as the main tenets for describing the ongoing changes in healthcare and defining the role of the physician as leaders and advocates for the Patient Care Culture.