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Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a shift from acute, episodic and reactive hospital-centered care toward longitudinal, person-centered and proactive home-centered care. The purpose of this paper is to contribute to the knowledge of a comprehensive development strategy for designing and providing home-centered care of older people.

The study design is based on qualitative research with an inductive approach. The authors study development initiatives at the national, regional and local levels of the Swedish health and social care system. The data collection methods included interviews (n = 54), meeting observations (n = 25) and document studies (n = 59).

The authors describe findings related to policy actions and system changes, attempts to achieve collaboration, integration and coordination, new forms of care offerings, characteristics of work settings at home and differences in patients' roles and participation at home and in the hospital.

The authors suggest home-centered care as a solution for providing person-centered and integrated care of older people and give examples of how this can be achieved.

The authors outline five propositions for research and development related to national policies, service modularity as a solution for customized and coordinated care, developing human resources and infrastructure for home settings, expanding services that enable older people living at home and patient co-creation.

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 healthcare suggested using patient-reported information to complement the information available in the medical records and administrative healthcare data to provide insights into patients' perceptions of satisfaction, experience and self-reported outcomes. However, little attention has been devoted to questions about factors fostering the use of patient-reported information to create value at the system level.

Action research design is carried out to elicit possible triggers using the case of patient-reported experience and outcome data for breast cancer women along their clinical pathway in the clinical breast network of Tuscany (Italy).

The case shows that communication and engagement of multi-stakeholder representation are needed for making information actionable in a multi-level, multispecialty care pathway organized in a clinical network; moreover, political and managerial support from higher level governance is a stimulus for legitimizing the use for quality improvement. At the organizational level, an external facilitator disclosing and discussing real-world uses of collected data is a trigger to link measures to action. Also, clinical champion(s) and clear goals are key success factors. Nonetheless, resource munificent and dedicated information support tools together with education and learning routines are enabling factors.

Current literature focuses on key factors that impact performance information use often considering unidimensional performance and internal sources of information. The use of patient/user-reported information is not yet well-studied especially in supporting quality improvement in multi-stakeholder governance. The work appears relevant for the implications it carries, especially for policymakers and public sector managers when confronting the gap in patient-reported measures for quality improvement.

The purpose of this study is to identify and synthesise the best evidence on health-care leaders’ and professionals’ experiences and perceptions of compassionate leadership.

A mixed-methods systematic review was conducted in accordance with the Joanna Briggs Institute methodology for mixed-methods systematic reviews using a convergent integrated approach. A systematic search was done in January 2023 in PubMed, CINAHL, Scopus, Medic and MedNar databases. The results were reported based on Preferred Reporting Items for Systematic Reviews and Meta-analyses. The data was analysed using thematic analysis.

Ten studies were included in the review (five qualitative and five quantitative). The thematic analysis identified seven analytical themes as follows: treating professionals as individuals with an empathetic and understanding approach; building a culture for open and safe communication; being there for professionals; giving all-encompassing support; showing the way as a leader and as a strong professional; building circumstances for efficient work and better well-being; and growing into a compassionate leader.

Compassionate leadership can possibly address human resource-related challenges, such as health-care professionals’ burnout, turnover and the lack of patient safety. It should be taken into consideration by health-care leaders, their education and health-care organisations when developing their effectiveness.

This review synthesised the knowledge of compassionate leadership in health care and its benefits by providing seven core elements of health-care leaders’ and professionals’ experiences and perceptions of compassionate leadership.

While transition programs are widely used to facilitate newly graduated nurses transition to healthcare settings, knowledge about preconditions for implementing such programs in the hospital context is scarce. The purpose of this study was to explore program coordinators’ perspectives on implementing a transition program for newly graduated nurses.

An explorative qualitative study using individual interviews. Total of 11 program coordinators at five acute care hospital administrations in a south-west region in Sweden. Data was subjected to thematic analysis, using NVivo software to promote coding.

The following two themes were identified from the analysis: Create a shared responsibility for introducing newly graduated nurses, and establish legitimacy of the program. The implementation process was found to be a matter of both educational content and anchoring work in the hospital organization. To clarify the what and why of implementing a transition program, where the nurses learning processes are prioritized, was foundational prerequisites for successful implementation.

This paper illustrates that implementing transition programs in contemporary hospital care context is a valuable but complex process that involves conflicting priorities. A program that is well integrated in the organization, in which responsibilities between different levels and roles in the hospital organization, aims and expectations on the program are clarified, is important to achieve the intentions of effective transition to practice. Joint actions need to be taken by healthcare policymakers, hospitals and ward managers, and educational institutions to support the implementation of transition programs as a long-term strategy for nurses entering hospital care.

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 COVID-19 pandemic has caused severe challenges to ethnic minorities in the UK. While the experiences of migrants are both complex and varied depending on individuals' social class, race, cultural proximity to the host country and acculturation levels, more in-depth studies are necessary to fully understand how COVID-19 affects specific migrant groups and their health. Taiwanese migrants were selected because they are an understudied group. Also, there were widespread differences in pandemic management between the UK and Taiwan, making this group an ideal case for understanding how their acculturation journey can be disrupted by a crisis.

Qualitative data were collected at two different time points, at the start of the UK pandemic (March/April 2020) and six months on (October/November 2020), to explore migrant coping experiences over time. Theoretically, the authors apply acculturation theory through the lens of coping, while discussing health-consumption practices, as empirical evidence.

Before the outbreak of the pandemic, participants worked hard to achieve high levels of integration in the UK. The pandemic changed this; participants faced unexpected changes in the UK’s sociocultural structures. They were forced to exercise the layered and complex “coping with coping” in a hostile host environment that signalled their new marginalised status. They faced impossible choices, from catching a life-threatening disease to being seen as overly cautious. Such experience, over time, challenged their integration to the host country, resulting in a loss of faith in the UK’s health system, consequently increasing separation from the host culture and society.

It is important to note that the Taiwanese sample recruited through Facebook community groups is biased and has a high level of homogeneity. These participants were well-integrated, middle-class migrants who were highly educated, relatively resourceful and active on social media. More studies are needed to fully understand the impact on well-being and acculturation of migrants from different cultural, contextual and social backgrounds. This being the case, the authors can speculate that migrants with less resource are likely to have found the pandemic experience even more challenging. More studies are needed to fully understand migrant experience from different backgrounds.

Public health policymakers are advised to dedicate more resources to understand migrants' experiences in the host country. In particular, this paper has shown how separation, especially if embraced temporarily, is not necessarily a negative outcome to be corrected with specific policies. It can be strategically adopted by migrants as a way of defending their health and well-being from an increasingly hostile environment. Migrants' home country experience provides vicarious learning opportunities to acquire good practices. Their voices should be encouraged rather than in favour of a surprising orthodox and rather singular approach in the discussion of public health management.

The paper has clear public health policy implications. Firstly, public health policymakers are advised to dedicate more resources to understand migrants' experiences in the host country. Acknowledging migrants' voice is a critical first step to contribute to the development of a fair and inclusive society. Secondly, to retain skilful migrants and avoid a future brain-drain, policymakers are advised to advance existing infrastructure to provide more incentives to support and retain migrant talents in the post-pandemic recovery phase.

This paper reveals how a group of previously well-integrated migrants had to exercise “coping with coping” during the COVID crisis. This experience, over time, challenged their integration to the host country, resulting in a loss of faith in the UK’s health system, consequently increasing separation from the host culture and society. It contributes to the understanding of acculturation by showing how a such crisis can significantly disrupt migrants' acculturation journey, challenging them to re-acculturate and reconsider their identity stance. It shows how separation was indeed a good option for migrants for protecting their well-being from a newly hostile host environment.

The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.

The methodology entails the integration of service design (SD) and action research (AR) methodologies, characterized by iterative phases that systematically alternate between action and reflective processes, fostering cycles of change and learning. Within this framework, stakeholders are engaged through semi-structured interviews, while the existing and envisioned processes are delineated and represented using BPMN 2.0. These methodological steps emphasize the development of an autonomous, patient-centric web application alongside the implementation of an adaptable and patient-oriented scheduling system. Also, business processes simulation is employed to measure key performance indicators of processes and test for potential improvements. This method is implemented in the context of the CP addressing transient loss of consciousness (TLOC), within a publicly funded hospital setting.

The methodology integrating SD and AR enables the detection of pivotal bottlenecks within diagnostic CPs and proposes optimal corrective measures to ensure uninterrupted patient care, all the while advancing the digitalization of diagnostic CP management. This study contributes to theoretical discussions by emphasizing the criticality of process optimization, the transformative potential of digitalization in healthcare and the paramount importance of user-centric design principles, and offers valuable insights into healthcare management implications.

The study’s relevance lies in its ability to enhance healthcare practices without necessitating disruptive and resource-intensive process overhauls. This pragmatic approach aligns with the imperative for healthcare organizations to improve their operations efficiently and cost-effectively, making the study’s findings relevant.

This study aims to emphasize the integration of lean start-up and design thinking approaches and investigate how they may be used together.

The report uses a systematic literature review methodology to analyze and summarize previous research on combining lean start-up and design thinking. Inferences were discovered and analyzed after relevant publications were chosen based on predetermined inclusion criteria.

The research shows that combining lean start-up and design thinking significantly impacts entrepreneurship. Start-ups can efficiently uncover consumer needs, reduce risks and improve their product or service offerings by combining the client-centricity of design thinking with the iterative and data-driven concepts of lean start-up. This integration promotes an innovative culture, gives teams the freedom to try new things and learn from mistakes and raises the possibility of start-up success.

The dependence on pre-existing literature, which might cover only some potential uses and circumstances, is a weakness of this research. It is advised that more empirical research be conducted to determine the precise circumstances in which the integrated strategy performs best. Future studies should also explore the difficulties and drawbacks of using these approaches to offer suggestions for overcoming them and maximizing their advantages.

The findings have significant ramifications for business owners and other professionals working in the start-up environment. The combination of lean start-up and design thinking emphasizes the relevance of early customer interaction and empathy-driven design. To foster creativity and hasten the expansion of start-ups, practitioners are urged to create a comprehensive strategy that integrates the advantages of both techniques. Through this integration, business owners may develop solutions that appeal to their target market, increasing adoption rates and market competitiveness.

This study is interesting in comparing lean start-up and design thinking, emphasizing the overlaps and benefits of their application to entrepreneurship. This study discusses successful start-up methods by offering suggestions for future research and practice. It also provides a basis for further developing and adopting the integrated approach.