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This study demonstrates how becoming a high-reliability institution in health care is a priority, given the high-risk environment in which an error can result in harm. Literature conceptually supports the need for highly reliable health care facilities but does not show a comprehensive approach to operationalizing the concept into the daily workforce to support patients. The Veterans Health Administration closes the gap by documenting a case study that not only demonstrates specific actions and functions that create a high-reliability organization (HRO) for safety and improvement but also created a learning organization by spreading the knowledge to other facilities.

The authors instituted a methodology consisting of assessments, training and educational simulations to measure, establish and operationalize activities that identified and prevented harmful events. Visual communication boards were created to facilitate team huddles and discuss improvement ideas. Improvements were then measured and analyzed for purposeful outcomes and return on investment (ROI).

HRO can be operationalized successfully in health care systems. Measurable outcomes verified that psychological safety was achieved through the identification and participation of 3,184 process improvement projects over a five-year period, which yielded a US$2.8m ROI. Documented processes and activities were used for educational teachings, which were disseminated to other Veteran Affairs Medical Center’s through the Truman HRO Academy.

This case study is limited to one hospital in the Veterans Health Administration (VHA) network. As the VHA continues to deploy the methods outlined to other hospitals, the authors will perform incremental data collection and ongoing analysis for further validation of the HRO methods and operations. Hospitalists can adapt the methods in the case study for practical application in a health care setting outside of VHA. Although the model is rooted in health care, the methods may be adapted for use in other industries.

This case study overcomes the limitations within literature regarding operationalizing HRO by providing actual activities and demonstrations that can be implemented by other health care facilities.

In response to shortages in personal protective equipment (PPE) during the COVID-19 pandemic, makers, community groups and manufacturers around the world utilised 3D printing to fabricate items, including face shields and face masks for healthcare workers and the broader community. In reaction to both local and global needs, numerous designs emerged and were shared online. In this paper, 37 face shields and 31 face masks suitable for fused filament fabrication were analysed from a fabrication perspective, documenting factors such as filament use, time to print and geometric qualities. 3D print times for similar designs varied by several hours, meaning some designs could be produced in higher volumes. Overall, the results show that face shields were approximately twice as fast to 3D print compared to face masks and used approximately half as much filament. Additionally, a face shield typically required 1.5 parts to be 3D printed, whereas face masks required five 3D printed parts. However, by quantifying the print times, filament use, 3D printing costs, part dimensions, number of parts and total volume of each design, the wide variations within each product category could be tracked and evaluated. This data and objective analysis will help makers, manufacturers, regulatory bodies and researchers consolidate the 3D printing response to COVID-19 and optimise the ongoing strategy to combat supply chain shortages now and in future healthcare crises.

Diffusion of innovations, defined as the adoption and implementation of new ideas, processes, products, or services in health care, is both particularly important and especially challenging. One known problem with adoption and implementation of new technologies is that, while organizations often make innovations immediately available, organizational actors are more wary about adopting new technologies because these may impact not only patients and practices but also reimbursement. As a result, innovations may remain underutilized, and organizations may miss opportunities to improve and advance. As innovation adoption is vital to achieving success and remaining competitive, it is important to measure and understand factors that impact innovation diffusion. Building on a survey of a national sample of 654 clinicians, our study measures the extent of diffusion of value-enhancing care delivery innovations (i.e., technologies that not only improve quality of care but has potential to reduce care cost by diminishing waste, Faems et al., 2010) for 13 clinical specialties and identifies healthcare-specific individual characteristics such as: professional purview, supervisory responsibility, financial incentive, and clinical tenure associated with innovation diffusion. We also examine the association of innovation diffusion with perceived value of one type of care delivery innovation – artificial intelligence (AI) – for assisting clinicians in their clinical work. Responses indicate that less than two-thirds of clinicians were knowledgeable about and aware of relevant value-enhancing care delivery innovations. Clinicians with broader professional purview, more supervisory responsibility, and stronger financial incentives had higher innovation diffusion scores, indicating greater knowledge and awareness of value-enhancing, care delivery innovations. Higher levels of knowledge of the innovations and awareness of their implementation were associated with higher perceptions of the value of AI-based technology. Our study contributes to our knowledge of diffusion of innovation in healthcare delivery and highlights potential mechanisms for speeding innovation diffusion.

The purpose of this study is to understand the meaning of the term well-being as conceptualised by parents, grandparents, principals and teachers in the Irish primary education system.

A hermeneutic phenomenological approach was adopted to understand the nature and meaning of the phenomenon of well-being. Interviews were carried out with 54 principals, teachers, parents and grandparents from a representative sample of primary schools in Ireland. Each participant was asked the same, open, question: “What does well-being mean to you?” Responses were transcribed verbatim and analysed using a combination of the principles of the hermeneutic circle and Braun and Clarke’s framework for thematic analysis.

Three conceptualisations of well-being were identified (1) well-being is about being happy, (2) well-being is about being healthy and safe and (3) well-being is something you “do”.

To the best of our knowledge this paper is the first of its kind to describe how well-being is conceptualised by adults in Irish primary school contexts. In particular it highlights how neoliberal conceptualisations of well-being as a “thing”, a commodity exchanged on assumptions of individualism, moralism and bio-economism, have crept into the education of our youngest citizens.

The consolidation process and morphology evolution in ceramics-based additive manufacturing (AM) are still not well-understood. As a way to better understand the ceramic selective laser sintering (SLS), a dynamic three-dimensional computational model was developed to forecast thermal behavior of hydroxyapatite (HA) bioceramic.

AM has revolutionized automotive, biomedical and aerospace industries, among many others. AM provides design and geometric freedom, rapid product customization and manufacturing flexibility through its layer-by-layer technique. However, a very limited number of materials are printable because of rapid melting and solidification hysteresis. Melting-solidification dynamics in powder bed fusion are usually correlated with welding, often ignoring the intrinsic properties of the laser irradiation; unsurprisingly, the printable materials are mostly the well-known weldable materials.

The consolidation mechanism of HA was identified during its processing in a ceramic SLS device, then the effect of the laser energy density was studied to see how it affects the processing window. Premature sintering and sintering regimes were revealed and elaborated in detail. The full consolidation beyond sintering was also revealed along with its interaction to baseplate.

These findings provide important insight into the consolidation mechanism of HA ceramics, which will be the cornerstone for extending the range of materials in laser powder bed fusion of ceramics.

Modern renewable energy is crucial for environmental conservation, sustainable economic growth and energy security, especially in developing East African nations that heavily use traditional biomass. Thus, this study aims to examine urbanization and modern renewable energy consumption (MREC) in East African community (EAC) while controlling for gross domestic product (GDP), population growth, foreign direct investment (FDI), industrialization and trade openness (TOP).

This study considers a balanced panel of five EAC countries from 1996 to 2019. Long-run dynamic ordinary least squares (DOLS) and fully modified ordinary least squares estimations were used to ascertain the relationships while the vector error-correction model was used to ascertain the causal relationship.

Results show that urbanization, FDI, industrialization and TOP positively affect MREC. Whereas population growth and GDP reduce MREC, the effect for GDP is not that significant. The study also found a bidirectional causality between urbanization, FDI, TOP and MREC in the long run.

Investing in modern renewable energy facilities should be a top priority, particularly in cities with expanding populations. The governments of the EAC should endeavor to make MREC affordable among the urban population by creating income-generating activities in the urban centers and sensitizing the urban population to the benefits of using MREC. Also, the government may come up with policies that enhance the establishment of lower prices for modern renewable energy commodities so as to increase their affordability.

MREC is a new concept in the energy consumption literature. Much of the research focuses on renewable energy consumption including the use of traditional biomass which contributes to climate change negatively. Besides, the influence of factors such as urbanization has not been given significant attention. Yet urbanization is identified as a catalyst for MREC.

As branded apps emerge as a marketing tool in the foodservice industry, the effort to manage them increases in the long term. This study aims to explore the determinants to continue the use of foodservice apps by adopting the post-acceptance model (PAM) of information systems continuance and the theory of planned behavior (TPB).

Based on a sample from a survey of 329 participants who use foodservice apps, a structural equation model analysis tested the relationships between the core constructs of both models.

The findings revealed the user confirmation of expectation leads to continued use of the app through satisfaction. Perceived usefulness, a key technology acceptance measure, however, has no direct effect on usage but on attitude. Among the salient behavioral beliefs of the TPB, only attitude and perceived behavioral control promoted continued use of the foodservice apps.

The study provided a framework to establish a practical strategy for foodservice firms by specifying important aspects, which induce the use of branded apps. Given that it is vital to meet users’ expectations to build branded-app loyalty, continuous interaction with users is required along with customized marketing.

On the basis of the PAM and the TPB, the findings contributed to developing and testing a model that motivates users to continue the use of foodservice branded apps. The study is significant, in that it enriched the PAM by integrating cognitive aspects to explore the psychological mechanisms in the post-adoption phase of foodservice app users.

Sustainability development goals (SDGs) cannot be achieved without a concerted effort from businesses and other organisations, being the corporate level is one of the keys to the achievement of SDGs. This study aims to explore the relationship between firms' adoption of SDG reporting in China and two main corporate-level factors, namely, board characteristics and ownership factors. Also, this study aims to determine which set of drivers – those related to board or ownership factors – exerts a greater influence on this reporting.

This research examines the impact of ownership and board-level factors on the SDG reporting of Chinese firms in the period 2016–2018, with a final sample of 455 firm-year observations operating in 11 activity sectors.

The results support the following: firstly, that board independence and size and the existence of a corporate social responsibility (CSR) committee favours firms addressing SDGs in their sustainability reporting while greater levels of foreign or institutional ownership are negatively related to a company's adoption of SDG reporting; secondly, two-stage logit regression results revealed that board-level factors exert greater explanatory power in the prediction of this reporting and have bigger weights in affecting the SDGs reporting.

This study focuses on assessing the drivers of SDGs; namely, what internal factors will facilitate companies' better implementation of SDG reporting to bridge the gap in this field, not only extending the investigation of corporate governance factors affecting SDGs but also examining the impact of corporate ownership on SDG reporting.

This study enriches and provides support for previous studies examining the drivers of SDGs in the private sector. In academia, addressing SDGs in business is still an emerging research stream that is still in an embryonic state; the reporting of SDGs in business is quite under-investigated in the sustainability literature. Moreover, literature on the drivers that promote better implementation of SDGs in business is even more scarce and incomplete. Some previous studies have ignored the impact of board size and the CSR committee. At the same time, there is no research to date on the impact of ownership on companies' SDGs reporting, which has been proved to play a large role in firms sustainability reporting.

The study aims to explore the validity of the modern renewable energy-environmental Kuznets curve (REKC) while considering the relevance of financial development in the consumption of modern renewable energy in East Africa Community (EAC). Modern renewable energy in this study includes all other forms of renewable energy except traditional use of biomass. The authors controlled for the effects of urbanization, governance, foreign direct investment (FDI) and trade openness.

Panel data of the five EAC countries of Burundi, Kenya, Rwanda, Tanzania and Uganda for the period 1996–2019 were used. The analysis relied on the use of the autoregressive distributed lag–pooled mean group (ARDL-PMG) model, and the data were sourced from the World Development Indicators (WDI), World Governance Indicators (WGI) and International Energy Agency (IEA).

The REKC hypothesis is supported for modern renewable energy consumption in the EAC region. Financial development positively and significantly affects modern renewable energy consumption, whereas urbanization, FDI and trade openness reduce modern renewable energy consumption. Governance is insignificant.

The concept of the REKC, although explored in other contexts such as aggregate renewable energy and in other regions, has not been used to explain the consumption of modern renewable energy in the EAC.