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To satisfy donors and reduce public procurement acquisition prices, Benin has implemented and amended its first public procurement code guided by top-down principles of good governance.

This study aims to measure the impact of the code and its amendment on public procurement acquisition prices of health-care equipment from 1995 to 2010.

A segmented linear regression analysis was performed using interrupted time-series data. The analysis shows that the code and its amendment did not reduce acquisition prices, indicating the limited impact of the code. The authors recommend the implementation of bottom-up processes in establishing the public procurement system, and the development of a reference pricelist of the most widely used health-care equipment, as possible solutions for improving the effectiveness of the code.

The purpose of this paper is to investigate how buyers and the vendors pursue alignment in collaborative purchasing (CP) of complex medical technologies.

Through a literature review in CP, the paper identify factors for shareholder alignment (i.e. aligning the needs of the buyers within the purchasing group) and customer alignment (i.e. aligning buyers’ needs with the vendors offering strategies) and investigate how they manifest in the case of CP of complex technology in the Danish National Healthcare System.

Shareholder alignment requires appropriate management of the relationships, expertise and guidance in simplifying procedures and effective management of the purchasing group. Customer alignment is facilitated by buyers’ understating of the vendor’s design options, which are moderated by the vendor’s design strategies.

The findings and generalizations from a single case study are limited to the complexity of the purchased technology and the specific cultural context. However the paper represents the first explorative study that poses the attention on the relevance of shareholder and customer alignment in CP.

The study can offer hospitals, vendors, governmental and regional institutions a better understanding about the alignment mechanisms for successful implementation of CP and how to avoid pitfalls.

Literature on CP is scarce as there are virtually no contributions that debate the key elements and tradeoffs that need to be considered for strategic alignment. The study addresses this gap.

Quality and value are currently convergent concepts in healthcare. The importance of patients as customers has increased the focus on quality management and value delivery. The Queen Elizabeth Hospital in Rotorua is a specialist hospital for rheumatic disease and rehabilitation. It has a clear mission for the delivery of customer quality and in fulfilling this mission uses a holistic approach (a value chain approach) to customer care. The value chain study of QEH’s product/service delivery has enabled medical, medical support staff and management to review both value delivery quality and delivery methods. The study explored the QEH value chain organisation and process structures and has identified questions concerning healthcare delivery and alternative methods for achieving current results and the future direction of the organisation. Value chain analysis encourages an intra‐ and inter‐organisational review of resource application and identifies alternative methods and structures for meeting objectives.

International businesses play a significant role in the growth, innovation and survival of technology-based firms (TBFs). Creating new opportunities in international markets, using communication networks and confronting constraints on available resources have distinguished the internationalization of small and medium-sized enterprises (SMEs) and intensified the importance of knowledge acquisition and continuous learning. This study aimed to (1) configure (the types and sources of) and (2) measure the internationalization knowledge of TBFs, by focusing on a knowledge-intensive part of the health industry in an emerging country: Iranian advanced medical equipment companies.

For this purpose, a qualitative approach was adopted to interview the leaders of eight TBFs exporting medical equipment. Obtained data were investigated using content analysis.

According to the content analysis results for configuration, technological knowledge and market knowledge were mainly obtained through direct experience and vicarious learning; however, internationalization knowledge is not so established as the third major knowledge area to integrate technological with market knowledge in line with corporate strategies of an internationalizing firm. For measurement of knowledge assets of internationalizing firms as a prerequisite for continuous improvement, several intellectual capital indices were extracted, including human, structural and relational capital.

This research complements existing literature in internationalization knowledge configuration via deploying an "Intellectual capital" perspective. It could enhance efforts for improving the learning of internationalizing SMEs, especially in the developing countries.

The long-term financial stability of hospital systems represents a “grand challenge” in health care. New ownership forms, such as private equity (PE), promise to achieve better financial performance than nonprofit or for-profit systems. In this study, we compare two systems with many similarities, but radically different ownership structures, missions, governance, and merger and acquisition (M&A) strategies. Both were nonprofit, religious systems serving low-income communities – Montefiore Health System and Caritas Christi Health Care.

Montefiore's M&A strategy was to invest in local hospitals and create an integrated regional system, increasing revenues by adding primary doctors and community hospitals as feeders into the system and achieving efficiencies through effective resource allocation across specialized units. Slow and steady timing of acquisitions allowed for organizational learning and balancing of debt and equity. By 2019, it owned 11 hospitals with 40,000 employees and had strong positive financials and low reliance on debt.

By contrast, in 2010, PE firm Cerberus Capital bought out Caritas (renamed Steward Health Care System) and took control of the Board of Directors, who set the system's strategic direction. Cerberus used Steward as a platform for a massive debt-driven acquisition strategy. In 2016, it sold off most of its hospitals’ property for $1.25 billion, leaving hospitals saddled with long-term inflated leases; paid itself almost $500 million in dividends; and used the rest for leveraged buyouts of 27 hospitals in 9 states in 3 years. The rapid, scattershot M&A strategy was designed to create a large corporation that could be sold off in five years for financial gain – not for health care integration. Its debt load exploded, and by 2019, its financials were deeply in the red. Its Massachusetts hospitals were the worst financial performers of any system in the state. Cerberus exited Steward in 2020 in a deal that left its physicians, the new owners, holding the debt.

In the healthcare management domain, there is a lack of knowledge concerning the role of resilience practices in improving patient safety. The purpose of this paper is to understand the capabilities that enable healthcare resilience and how digital technologies can support these capabilities.

Within- and cross-case research methodology was used to study resilience mechanisms and capabilities in healthcare and to understand how digital health technologies impact healthcare resilience. The authors analyze data from two Italian hospitals through the lens of the operational failure literature and anchor the findings to the theory of dynamic capabilities.

Five different dynamic capabilities emerged as crucial for managing operational failure. Furthermore, in relation to these capabilities, medical, organizational and patient-related knowledge surfaced as major enablers. Finally, the findings allowed the authors to better explain the role of knowledge in healthcare resilience and how digital technologies boost this role.

When trying to promote a culture of patient safety, the research suggests healthcare managers should focus on promoting and enhancing resilience capabilities. Furthermore, when evaluating the role of digital technologies, healthcare managers should consider their importance in enabling these dynamic capabilities.

Although operations management (OM) research points to resilience as a crucial behavior in the supply chain, this is the first research that investigates the concept of resilience in healthcare systems from an OM perspective, with only a few authors having studied similar concepts, such as “workaround” practices.

The purpose of this paper is to analyze a conceptual framework to identify significant benefit and cost attributes of a radio-frequency identification (RFID) system for asset tracking in healthcare facilities. Sources of value function for RFID in healthcare are categorized according to major improvement. Several cost functions are proposed to measure aspects of automated tracking implementation.

The four phases of problem definition, literature identification, assessment and analysis were used to begin the research. A cost–benefit analysis (CBA) was completed to identify the factors within healthcare with major benefits, and finally, a recommended group of items were identified to track with the CBA.

RFID to manage mobile devices increases the utilization rate, decreases annual spending, allows withdrawal of funds for underutilized assets and establishes confidence that equipment is readily available when needed. These benefits provide improved staff productivity, quicker patient turnover, higher quality of care and more cost savings. Real-time location system technologies allow hospitals to be prepared for emergencies requiring the immediate use of medical devices without delay and allow staff to determine the status, condition and location of essential equipment, leading to a decrease in patient wait time. Additional improvements were also found.

The transition from pay-for-service to pay-for-performance is taking place in an industry hampered by rising costs and limited available resources. Healthcare expenditures are estimated to grow dramatically, and various factors contribute to rising expenses, including an aging population and increased chronic conditions resulting in higher demand for care, poor quality and operational inefficiencies. Therefore, understanding benefits of new technology use like RFID is critical for improvement and efficiency in healthcare.

The purpose of this systematic review was to explore the benefits and challenges in the implementation of simulation-based education (SBE) in the classroom and clinical settings in sub-Saharan Africa. The objectives of this systematic review were to identify the benefits of utilising SBE in the classroom and clinical practice in sub-Saharan Africa and to assess the challenges in the implementation of SBE in the classroom and clinical practice in sub-Saharan Africa.

Five databases were searched for existing English literature (Medline, CINAHL and Science Direct), including grey literature on the subject. Out of 26 eligible studies conducted in sub-Saharan Africa between 2014 and 2021, six studies that used mixed-methods design were included. Hawker et al.’s framework was used to assess the quality of the studies. Quantitative data were presented using descriptive and inferential statistics in the form of means and standard deviations while qualitative data were analysed and presented thematically.

Quantitative findings showed that participants rated SBE highly in terms of teaching (93.2%), learning (91.4%) and skill acquisition (88.6%). SBE improved the clinical skill competency from 30% at baseline to 75% at the end. On the other hand, qualitative findings yielded themes namely: improved confidence and competence; knowledge acquisition and critical thinking; motivation and supervision; independent, self-paced learning; simulation equipment and work schedules; and planning and delivery of simulation activity. Pedagogical skills, competence and confidence are some of the elements that determine the feasibility of implementing SBE in the classroom and clinical settings.

SBE could help to bridge the gap between theory and practice and improve the quality of care provided by nurses. Simulation-based training is effective in improving the clinical skills of midwives and increasing their confidence in providing care. However, SBE trainees require motivation and close supervision in classroom settings if simulation is to be successfully implemented in sub-Saharan Africa. Furthermore, careful planning of scenarios, students briefing and reading of content prior to implementation facilitate effective simulation.

While there may be a lack of literature on the use of SBE for training nurses and midwives in the developing world, there is growing evidence that it can be an effective way to improve clinical skills and quality of care. However, there are also significant challenges to implementing simulation-based training in resource-limited settings, and more research is needed to understand how best to address these challenges. This study fills this gap in the literature.

Many advanced technologies applied to maintenance are aimed at data analysis and not directly at the execution of activities. Considering the lack of studies that analyze the use of technologies with a focus on aiding maintenance activities, this study aims to investigate the applicability of advanced technologies capable of mitigating ergonomic risks in mining maintenance activities.

A mixed-method study approach was performed in the most important Brazilian mining company, where three groups of equipment were observed: pumps, crushers and sieves. Qualitative and quantitative data were collected, including structured interviews with 60 maintenance professionals for the equipment, and a workshop was held to evaluate the applicability of these technologies in the maintenance activity of this equipment.

It was verified that the load handler, weight cancelers and automatically guided vehicle technologies were assessed as capable of mitigating ergonomic problems of the supporting the weight of parts and tools and the human traction during maintenance activities.

The study observed only one company, and the five technologies analyzed here are not yet a reality in this sector.

This research directs maintenance managers in the implementation of process improvements, in the incorporation of technologies capable of mitigating the ergonomic problems experienced by the maintenance professionals. In this way, it is expected to reduce the number of absences from work and improve the working conditions of these professionals.

Mining activities impact the local economy and are important in the development of technologies that improve productivity and the man–work relationship. The demands of industries for new solutions encourage local technological development through an approximation with university research and development centers. At the same time, it is observed that these centers can help in the formation of competences to act, either in the implementation of these technologies or in their handling. This university–company integration, in addition to benefiting the mining segment, has the potential to expand the solution to different supply chains, which proves to be a relevant social impact.

This study is pioneering in understanding the use of advanced technologies in maintenance activities in the context of the mining industry (extractive primary sector).

Researchers recommend a reorganization of the medical profession into larger groups with a multispecialty mix. We analyze whether there is evidence for the superiority of these models and if this organizational transformation is underway.

We summarize the evidence on scale and scope economies in physician group practice, and then review the trends in physician group size and specialty mix to conduct survivorship tests of the most efficient models.

The distribution of physician groups exhibits two interesting tails. In the lower tail, a large percentage of physicians continue to practice in small, physician-owned practices. In the upper tail, there is a small but rapidly growing percentage of large groups that have been organized primarily by non-physician owners.

While our analysis includes no original data, it does collate all known surveys of physician practice characteristics and group practice formation to provide a consistent picture of physician organization.

Our review suggests that scale and scope economies in physician practice are limited. This may explain why most physicians have retained their small practices.

Larger, multispecialty groups have been primarily organized by non-physician owners in vertically integrated arrangements. There is little evidence supporting the efficiencies of such models and some concern they may pose anticompetitive threats.

This is the first comprehensive review of the scale and scope economies of physician practice in nearly two decades. The research results do not appear to have changed much; nor has much changed in physician practice organization.