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This work aims to integrate the concepts generated by a systematic literature review on patient flows in emergency departments (ED) to serve as a basis for developing a generic process model for ED.

A systematic literature review was conducted using PRISMA guidelines, considering Lean Healthcare interventions describing ED patients’ flows. The initial search found 141 articles and 18 were included in the systematic analysis. The literature analysis served as the basis for developing a generic process model for ED.

ED processes have been represented using different notations, such as value stream mapping and workflows. The main alternatives for starting events are arrival by ambulance or walk-in. The Manchester Triage Scale (MTS) was the most common protocol referred to in the literature. The most common end events are admission to a hospital, transfer to other facilities or admission to an ambulatory care system. The literature analysis allowed the development of a generic process model for emergency departments. Nevertheless, considering that several factors influence the process of an emergency department, such as pathologies, infrastructure, available teams and local regulations, modelling alternatives and challenges in each step of the process should be analysed according to the local context.

A generic business process model was developed using BPMN that can be used by practitioners and researchers to reduce the effort in the initial stages of design or improvement projects. Moreover, it’s a first step toward the development of generalizable and replicable solutions for emergency departments.

This article aims to clarify the concepts used to understand, analyze and improve a patient’s progress through a health service system. A patient pathway describes plans and intentions. Within it, we distinguish between the clinical pathway of decisions and interventions and the care pathway of supportive activities. As a patient pathway is implemented, it turns into a patient journey of what is done, what happens to a patient’s medical condition and what is experienced and felt. We introduce “patient journey disruption” (PJD) as a concept describing the events that need to be prevented from happening to accomplish integrated, coordinated and seamless care.

The method used in this paper is concept analysis. First, an expert steering group worked to refine the concept of PJDs; second, an analysis of similar concepts from related fields was done to root the concept into existing theories, and third, semi-structured interviews with professionals and patients were done to test the concept of PJDs in the home care context.

PJDs are agency-based harmful events in the execution of the care pathway that deviate the patient journey from what can be reasonably expected. PJDs are management failures, which is why they should be studied by healthcare operations management (HOM) and service science scholars with the intention to find ways to prevent them from happening.

This study has limitations, including presenting conceptual ideas and preliminary results that are only indicative.

We believe that the introduction of the concept of PJDs into the literature provides a new, systematic way of approaching the different shortcomings in our healthcare production systems. Moreover, by systematically identifying different PJDs, interventions can be designed and targeted more appropriately.

Managerial challenges regarding healthcare processes have been studied but have not been well defined. The concept of PJDs is an original, well-thought-out definition.

Research indicated that dietary antioxidants could improve immune system performance. This study aims to investigate the association of COVID-19 symptoms, total antioxidant capacity and serum inflammatory markers, with dietary antioxidants intake among angina patients.

A food frequency questionnaire was used in a cross-sectional study among 135 angina patients with COVID-19, to assess dietary antioxidants consumption. Serum levels of tumor necrosis factor, interleukin 1ß, malondialdehyde, high-sensitivity C-reactive protein and total antioxidant capacity were measured by enzyme-linked immunosorbent assay methods.

Among study angina patients, 76.67% followed unhealthy food patterns and 23.33% followed anti-inflammatory dietary patterns before hospitalization. The angina patients with anti-inflammatory food pattern had less fever (p = 0.021), cough (p = 0.018), dyspnea (p = 0.024), diarrhea (p = 0.014) and pneumonia severity index (p = 0.014) compared to patients with unhealthy food pattern. The serum levels of tumor necrosis factor, interleukin 1ß, high-sensitivity C-reactive protein and malondialdehyde, had a significantly negative association with dietary antioxidants intake (p < 0.05).

There are significant association between antioxidant intake with serum inflammation markers in COVID-19 patients. There is a need for more clinical trial studies for approval of these results.

Artificial intelligence (AI) applications are increasingly used for day-to-day operations in healthcare. Each has a relatively limited scope or task, and several find application in managerial and organizational processes. More and more, AI and machine learning (ML) devices have received US FDA approval in the last decade. This chapter covers the main AI applications in healthcare, with a focus on organizational AI solutions (administrative AI), the main AI developers, their investment and real-world data and case studies in healthcare and other sectors. AI can be applied in resource management and procurement, resource allocation, clinical case management, staff work shift scheduling and handling of emergencies. AI applications are becoming ubiquitous in hospital (e.g. emergency room and operating theatre) and outpatient settings (e.g. ambulatory care and dentistry clinics). Their implementation is expected to bring direct benefits for patient care and satisfaction. This chapter gives a broad definition of AI in healthcare settings, with a focus on administrative applications and their use in case study data.

MBA.

Master’s level in Change Management, Organizational Leadership and Human Resource Management.

Mr Sharma, the dynamic and entrepreneurial Chief Executive Officer (CEO) of the newly formed Soni Manipal Hospital (SMH), Jaipur, and Unit Head, Manipal Hospitals [Manipal Health Enterprises Pvt Ltd. (MHEPL)], in a meeting with SMH’s Head of Human Resources and the Head of the Nursing Management, Mr Yaduvanshi realised the exponential growth of employee resistance, their lack of skills and technological advancements for documentation hindering the hospital's transformation goal. The case study highlighted the challenges the protagonist faced when taking charge as the CEO after nine months of acquisition and the factors contributing to them.

Students reading this case are expected to understand leadership theories, strategic and quality management approaches, and theories of social behaviour, such as Herzberg’s two-factor theory and social exchange theory (SET) and the application of these concepts in acquired organisations to develop healthy leadership–employee relations and change management theories.

Teaching notes are available for educators only.

CSS 6: Human resource management.

Malnutrition has a significant effect on the onset and progression of infective pathology. The malnutrition status in COVID-19 cases are not understood well. Prognostic Nutritional Index (PNI) is a new and detailed assessment of nutrition and inflammation cases. This study aims to investigate the effect of PNI on mortality in COVID-19 patients.

In total, 334 patients (males, 142; females, 192; 64.5 ± 12.3 years of age) with COVID-19 bronchopneumonia were enrolled in this investigation. Cases were divided into two groups with respect to survival (Group 1: survivor patients, Group 2: non-survivor patients). Demographic and laboratory variables of COVID-19 cases were recorded. Laboratory parameters were calculated from blood samples taken following hospital admission. PNI was calculated according to this formula: PNI = 5 * Lymphocyte count (10⁹/L) + Albumin value (g/L).

When the patients were assessed with respect to laboratory values, leukocytes, neutrophils, CRP, ferritin, creatinine and D-Dimer parameters were significantly lower in Group 1 patients than Group 2 patients. Nevertheless, serum potassium value, lymphocyte count, calcium and albumin values were significantly higher in Group 1 cases than in Group 2 cases. PNI value was significantly lower in Group 2 cases than in Group 1 cases (39.4 ± 3.7 vs 53.1 ± 4.6).

In this retrospective study of COVID-19 cases, it can be suggested that PNI may be a significant risk factor for mortality. In conclusion of this research, high-risk patients with COVID-19 can be determined early, and suitable medical therapy can be begun in the early duration.

This paper explores the Adoption of Technological Innovation (ATI) in the healthcare industry. It investigates how the literature has evolved, and what are the emerging innovation dimensions in the healthcare industry adoption studies.

We followed a mixed-method approach combining bibliometric methods and topic modeling, with 57 papers being deeply analyzed.

Our results identify three latent topics. The first one is related to the digitalization in healthcare with a specific focus on the COVID-19 pandemic. The second one groups up the word combinations dealing with the research models and their constructs. The third one refers to the healthcare systems/professionals and their resistance to ATI.

The study’s sample selection focused on scientific journals included in the Academic Journal Guide and in the FT Research Rank. However, the paper identifies trends that offer managerial insights for stakeholders in the healthcare industry.

ATI has the potential to revolutionize the health service delivery system and to decentralize services traditionally provided in hospitals or medical centers. All this would contribute to a reduction in waiting lists and the provision of proximity services.

The originality of the paper lies in the combination of two methods: bibliometric analysis and topic modeling. This approach allowed us to understand the ATI evolutions in the healthcare industry.

This article aims to provide the current state of the art of the literature on the contribution of information and communication technologies (ICTs) on the measurement and management of performance in the healthcare sector. In particular, the work aims to identify current and emerging ICTs and how these relate to the performance measurement and management (PMM) cycle of healthcare organizations.

To address the research objective, we adopted a systematic literature review. In particular, we used the preferred reporting items for systematic reviews and meta-analysis (PRISMA) methodology to select articles related to the investigated topic. Based on an initial screening of 560 items retrieved from Scopus and ISI Web of Knowledge, we identified and analyzed 58 articles dealing with ICTs and PMM in the healthcare sector. The last update of the dataset refers to February 2024.

Although we attempted to address a relevant topic for both research and practice, we noticed that a relatively small sample of articles directly addressed it. Through this literature review, in addition to providing descriptive statistics of research on ICTs and PMM in healthcare, we identified six theoretical clusters of scientific streams focusing on the topic and eleven categories of ICTs effectively tackled by the literature. We then provided a holistic framework to link technologies to the different PMM phases and functions.

Nowadays, the availability of ICTs to support healthcare organizations’ processes and services is extensive. In this context, managers at various organizational levels need to understand and evaluate how each ICT can support different activities to benefit most from their adoption. The findings of this study can offer valuable insights to top and line managers of healthcare organizations for planning their investments in both existing and emerging ICTs to support the various stages of development and functions of PMM.

Most of the current literature focusing on ICTs in the healthcare sector refers to the contribution that technology provides to clinical processes and services, devoting limited attention to the impact of ICTs on administrative processes, such as PMM. To the best of the authors’ knowledge, this represents the first literature review on the contribution of ICTs to PMM in the healthcare sector. The review, differently from other research focused on specific ICTs and/or specific PMM functions, provides a holistic perspective to understand how these technologies may support healthcare organizations and systems in measuring and managing their performance.

The purpose of this research is to examine the relationship between high- performance work systems (HPWS) and organisational innovation in hospital settings, examining the role of employee engagement as a mediator in this relationship. Additionally, the study aims to investigate the moderating role of perspective-taking between HPWS and employee engagement as well as the moderating effect of trust in leader on the connection between employee engagement and organisational innovation.

A quantitative-deductive causal method, along with a cross-sectional approach, was utilized. Structural equation modelling was applied to analyse data from a sample of 530 doctors employed in hospitals, practicing human resources management in the public and private sectors of Sindh province, Pakistan.

The findings show positive effects of HPWS on employee engagement and organisational innovation. Additionally, employee’s engagement partially mediates the relationship between HPWS and organisational innovation, while the moderating role of perspective-taking significantly influences the link between HPWS and employee engagement.

While HPWS are recognized for enhancing organisational innovation, this study confirms their positive effects on individual and organisational outcomes, particularly within the healthcare sector in Pakistan. This study suggests that when HPWS are effectively perceived and implemented, these integrated practices can be beneficial for both employees and organizations, even in challenging situations.

The purpose of this paper is to describe the perception of real teamwork and sustainable quality culture as well as success factors for achieving a sustainable quality culture within an organisation, focusing on top management teams (TMTs). An additional purpose is to explore the relationship between real teamwork and sustainable quality culture.

A mixed-methods design focusing on TMTs was used. Four TMTs were open-sampled and located in different parts of Sweden. The data were collected through questionnaires and focus group discussions between April 2022 and December 2022. Follow-up meetings were thereafter held with the participants. A meta-analysis was conducted of the data from the four TMTs.

Two overarching conclusions of this study were: to follow the developed methodology can be one way to increase TMTs' abilities for real teamwork alongside a sustainable quality culture, and the results also showed the importance of a systems view, emotional commitment and continuous improvement for improving real teamwork and creating a sustainable quality culture.

Practical implications were suggestions on how to increase the TMTs' abilities for real teamwork alongside a sustainable quality culture. A deepened understanding of real teamwork and a sustainable quality culture was also achieved by the participants.

The novelty of this paper is the use of a new methodology for assessing teamwork and sustainable quality culture. To the authors' knowledge, no similar research has previously been performed to investigate teamwork alongside a sustainable quality culture, focusing on TMTs.