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Negative issues in the world have increased in recent years. The continuing COVID-19 pandemic has forced the global tourism industry to take precautions against these disasters to be ready to respond. Given tourism's vulnerability to environmental and social changes, the pandemic has dramatically impacted tourism worldwide. Tourism enterprises have developed various strategies and approaches to eliminate vulnerabilities that negatively affect their structures. This chapter tries to measure and recover plans implemented by various countries to increase the tourism industry's resilience in the face of crises and disasters.

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.

Early writings about teamwork in healthcare emphasized that healthcare providers needed to evolve from a team of experts into an expert team. This is no longer enough. As patients, accreditation bodies, and regulators increasingly demand that care is coordinated, safe, of high quality, and efficient, it is clear that healthcare organizations increasingly must function and learn not only as expert teams but also as expert multiteam systems (MTSs).

In this chapter, we offer a portrait of the robust, and albeit complex, multiteam structures that many healthcare systems are developing in order to adapt to rapid changes in regulatory and financial pressures while simultaneously improving patient safety, quality, and performance.

The notion of continuous improvement rooted in continuous learning has been embraced as a battle cry from the boardroom to the bedside, and the MTS concept offers a meaningful lens through which we can begin to understand, study, and improve these complex organizational systems dedicated to tackling some of the most important goals of our time.

Workplace voice is well-established and encompasses behaviors such as prosocial voice, informal complaints, grievance filing, and whistleblowing, and it focuses on interactions between the employee and supervisor or the employee and the organizational collective. In contrast, our chapter focuses on employee prosocial advocacy voice (PAV), which the authors define as prosocial voice behaviors aimed at preventing harm or promoting constructive changes by advocating on behalf of others. In the context of a healthcare organization, low quality and unsafe patient care are salient and objectionable states in which voice can motivate actions on behalf of the patient to improve information exchanges, governance, and outreach activities for safer outcomes. The authors draw from the theory and research on responsibility to intersect with theories on information processing, accountability, and stakeholders that operate through voice between the employee-patient, employee-coworker, and employee-profession, respectively, to propose a model of PAV in patient-centered healthcare. The authors complete the model by suggesting intervening influences and barriers to PAV that may affect patient-centered outcomes.

Healthcare provision in Denmark reflects some of the key principles of the welfare state. By securing relatively easy and equal access for all Danish residents regardless of income via general tax financing, the Danish healthcare system has strong ethical merits. All residents are entitled to comprehensive healthcare services. The Danish healthcare system is also relatively efficient. Total healthcare expenditures – including public and private – amount to 10% of GDP, above the OECD 8.8% average but well below the costs in the other Nordic countries, Germany, Switzerland and the United Stated. Notwithstanding its merits, healthcare in Denmark shares key predicaments with other OECD countries, primarily how to improve health outcomes while containing care expenditures. All of the OECD countries aim to improve population life expectancy and health quality. Yet their ageing and increasingly obese populations are exacerbating the demands on their respective healthcare systems. This chapter examines changes in how Denmark has managed these challenges. The main argument is that the healthcare system performance on managing health outcomes and costs improved remarkably from the 1990s to the early 2020s, although outcome inequalities remain. Notable changes in the system were targeted innovations in treatment procedures and expansion of municipal rehabilitation and preventive efforts, along with strict budget controls.

This chapter aims to provide suggestive evidence on how the Lombardy region dealt with the COVID-19 pandemic in 2020 and discuss future challenges for the Lombardy healthcare system. After an introduction to the wide spread of the virus inside the region, we describe the Lombardy health system so the reader may understand the context in which the virus has taken hold so quickly. The pandemic has heavily stressed the system, mainly because Lombardy experienced an excess of hospital admissions. We have considered the increased mortality rate as a proxy of the proper managing of the COVID-19 pandemic. In addition, we describe the process of treating non-COVID patients, such as those affected by acute myocardial infarction (AMI), stroke and oncological diseases. Despite the pandemic, hospitals have been able to guarantee a high level of performance. A discussion of the future evolution of the healthcare system concludes this chapter.

This chapter integrates organization design and sustainability concepts to describe an accelerated transformational change at the Fairview Medical Group (United States).

A case study of the transformation at Fairview Medical Group’s primary care clinics was developed from interviews and first-person accounts of the change. Objective data regarding outcomes was used to evaluate the effectiveness of the redesign process.

The Fairview Medical Group developed an innovation and change capability to transform 35 primary care clinics in six months. All of the clinics were certified by the state of Minnesota as complying with their healthcare standards. Clinical outcomes, costs, and employee and physician engagement also increased. All of the improved measures are sustained.

Healthcare reform in the United States struggles because the organization design challenges are great and the change difficulties even greater. Fairview’s experience provides important evidence and lessons that can help advance our understanding of effective healthcare and create more sustainable healthcare systems. This chapter provides healthcare system administrators evidence and alternatives in the pursuit of implementation.

The public healthcare system faces challenges and limitations regarding the supply and delivery of healthcare services. The private healthcare system is expensive and only affordable for some. Due to the increasing population, developing countries face a greater degree of demand–supply mismatch. The existing healthcare services in developing countries need to be more sustainable due to high out-of-pocket expenditures and low-income levels. The research design used in this chapter is a case study approach based on qualitative data. The study focuses on two objectives: (1) to have a detailed understanding of the nature of healthcare cooperatives in Spain and their contribution to meeting healthcare requirements; and (2) to make suggestions and recommendations for an improved and sustainable healthcare cooperative for developing countries. Inspired by the healthcare cooperative model of Spain and keeping in mind the ground reality of the lack of healthcare facilities and services accessible and affordable in developing countries, the authors have developed a conceptual framework with the foundation of an insurance cooperative. The Spain Model is sustainable for developing countries as it serves the interest of all income brackets, not leaving the low-income population behind. Concepts like cooperative worker insurance embedded in the model can ensure that the beneficiaries receive timely and good quality health services at an affordable price. It empowers individuals by allowing them to make small amounts of investments as premiums to secure a hopeful future for a healthy life.