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This paper aims to introduce a model using a digital twin concept in a cold heading manufacturing and develop a digital visual management (VM) system using Lean overall equipment effectiveness (OEE) tool to enhance the process performance and establish Fourth Industrial Revolution (I4.0) platform in small and medium enterprises (SMEs).

This work utilised plan, do, check, act Lean methodology to create a digital twin of each machine in a smart manufacturing facility by taking the Lean tool OEE and digitally transforming it in the context of I4.0. To demonstrate the effectiveness of process digitisation, a case study was carried out at a manufacturing department to provide the data to the model and later validate synergy between Lean and I4.0 platform.

The OEE parameter can be increased by 10% using a proposed digital twin model with the introduction of a Level 0 into VM platform to clearly define the purpose of each data point gathered further replicate in projects across the value stream.

The findings suggest that researchers should look beyond conversion of stored data into visualisations and predictive analytics to improve the model connectivity. The development of strong big data analytics capabilities in SMEs can be achieved by shortening the time between data gathering and impact on the model performance.

The novelty of this study is the application of OEE Lean tool in the smart manufacturing sector to allow SME organisations to introduce digitalisation on the back of structured and streamlined principles with well-defined end goals to reach the optimal OEE.

Ireland’s ageing population has resulted in an increasing number of older adults living with frailty. Despite growing attention towards older adults’ and health professionals’ perspectives of frailty, occupational therapy research is limited. This study aims to explore occupational therapists’ perceptions of frailty and how their perceptions impact their approach to the assessment and management of frailty.

Using qualitative descriptive design, 19 occupational therapists working with older adults participated in online focus groups. Data were analysed using thematic analysis.

Perceptions of occupational therapists were constructed into three main themes: conceptualising frailty; management of frailty; and advancing frailty practice. Findings indicate that occupational therapists perceived frailty as a multidimensional concept but highlight a reluctance to use frailty terminology with patients. Findings also suggest that although occupational therapists are involved in provision of care for older adults living with frailty, the profession’s scope is not optimised in the assessment and management of frailty.

Findings provide insight into occupational therapists’ perceptions of frailty. Development of a shared understanding of frailty between clinicians and patients and enhancement of undergraduate frailty education are recommended to progress occupational therapy’s role in frailty management.