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This article analyzes the cognitive microfoundations, conflicting institutional logics and professional hybridization in a case characterized by conflict.

In contrast to the majority of earlier studies focusing on special health care, the study was conducted in a Finnish basic health care organization. The empirical data include 36 interviews, accounting reports, budgets, newspaper articles and meeting notes collected 2013–2018.

The use of accounting techniques in this case did not offer professionals sufficient support under conditions of conflict. The authors suggest that this perceived lack of support intensified the negative emotions toward accounting techniques. These negative emotions aggregated into incompatible professional-level institutional logics, which contributed to the lack of hybridization between such logics. The authors highlight the importance of the cognitive microfoundations, that is, the individual-level interpretations and emotional responses, in the analysis of conflicting institutional logics.

Managerial attention needs to be directed to accounting practices perceived as frustrating or threatening, a perception that can prevent the use of accounting techniques in the creation of professional hybrids. The Finnish basic health care context involves inconsistent political decision-making, multiple tasks, three institutional logics and individual interpretations and emotions in various decision-making situations.

This study develops microfoundational accounting research by illustrating how individual-level cognitive microfoundations such as dissatisfaction with budgeting, aggregate into professional-level institutional logics, and in our case, prevent professional hybridization in a basic health care setting characterized by conflict and three separate institutional logics.

The purpose of this mixed-methods study was to explore how medical secretaries experience digital transformation in a Swedish healthcare organisation, with a focus on workplace climate and health.

Data were collected using a sequential exploratory mixed-methods design based on grounded theory, with qualitative data collection (a Quality Café and individual interviews) followed by quantitative data collection (a questionnaire).

Four categories with seven underlying factors were identified, emphasising the crucial need for effective organisation of digital transformation. This is vital due to the increased knowledge and skills in utilising technology. The evolving roles and responsibilities of medical secretaries in dynamic healthcare settings should be clearly defined and acknowledged, highlighting the importance of professionality. Ensuring proper training for medical secretaries and other occupations in emerging techniques is crucial, emphasising equal value and knowledge across each role. Associations were found between some factors and the health of medical secretaries.

This study adds to the knowledge on digital transformation in healthcare by examining an important occupation. Most data were collected online, which may be a limitation of this study.

Several aspects of the medical secretaries’ experiences were identified. Knowledge of these is valuable for healthcare managers to make digital transformation more effective while avoiding excessive strain on medical secretaries.

Medical secretaries are expected to contribute to the digitalisation of healthcare. However, minimal research has been conducted on the role of medical secretaries in workplace digitalisation, focusing on workplace roles and its dynamics.

The COVID-19 pandemic significantly increased demand for medical and protective equipment by frontline health workers, as well as the general community, causing the supply chain to stretch beyond capacity, an issue further heightened by geographical and political lockdowns. Various 3D printing technologies were quickly utilised by businesses, institutions and individuals to manufacture a range of products on-demand, close to where they were needed. This study gathered data about 91 3D printed projects initiated prior to April 1, 2020, as the virus spread globally. It found that 60% of products were for personal protective equipment, of which 62% were 3D printed face shields. Fused filament fabrication was the most common 3D print technology used, and websites were the most popular means of centralising project information. The project data provides objective, quantitative insight balanced with qualitative critical review of the broad trends, opportunities and challenges that could be used by governments, health and medical bodies, manufacturing organisations and the 3D printing community to streamline the current response, as well as plan for future crises using a distributed, flexible manufacturing approach.

The purpose of this study is to examine the role of artificial intelligence (AI) in transforming the healthcare sector, with a focus on how AI contributes to entrepreneurship and value creation. This study also aims to explore the potential of combining AI with other technologies, such as cloud computing, blockchain, IoMT, additive manufacturing and 5G, in the healthcare industry.

Exploratory qualitative methodology was chosen to analyze 22 case studies from the USA, EU, Asia and South America. The data source was public and specialized podcast platforms.

The findings show that combining technologies can create a competitive advantage for technology entrepreneurs and bring about transitions from simple consumer devices to actionable healthcare applications. The results of this research identified three main entrepreneurship areas: 1. Analytics, including staff reduction, patient prediction and decision support; 2. Security, including protection against cyberattacks and detection of atypical cases; 3. Performance optimization, which, in addition to reducing the time and costs of medical procedures, includes staff training, reducing capital costs and working with new markets.

This study demonstrates how AI can be used with other technologies to cocreate value in the healthcare industry. This study provides a conceptual framework, “AI facilitators – AI achievers,” based on the findings and offer several theoretical contributions to academic literature in technology entrepreneurship and technology management and industry recommendations for practical implication.

The purpose of this study is to analyse the crisis network response of European countries and the role played by defence organizations (DOs) during the early response phase of the pandemic, here set to encompass 75 days.

Published materials – reports, news and communications – provided by authorities and DOs were used. Some of the authors actively participated in national pandemic response networks. An exploratory approach and qualitative content analysis were applied. The data were collected in national languages from 13 European countries, and they were coded and analysed using the actors, resources and activities (ARA) framework.

This study identified three main categories of activity structures in which the DOs interacted with civilian members of response networks, health-related services, logistics services and public support services. These networks among actors were found within formal response systems and emergent networks. The DOs engaged as actors that provided a range of services when civil authorities could not cope with the huge demand for specific services and when resources were scarce in the initial response phase.

This study contributes by filling an important research gap with regard to the civil-military relations associated with the use of DO resources in the civil response to the pandemic crisis in Europe, which is described as an untraditional response. The ARA network approach provides a framework for arranging ARA and extends the wider civil-military network to expand the formal networks of the early crisis response. The study lays knowledge about the co-operation between civilian and military actors in different contexts and provides a broader understanding of the roles that DOs played in the response operations.

The purpose of this paper is to review the causes of long waiting time in Hong Kong public hospitals and to suggest solutions in the service, organisational, systems, financial and policy perspectives.

The paper is a review of waiting time of public hospital services. Total joint replacement, which is one of the elective surgeries in public hospitals, is presented as a case study.

The average waiting time of semi-urgent and non-urgent patients in the accident and emergency departments of public hospitals is two hours, and that of specialist outpatient (SOP) clinics is from 1 to 144 weeks. For total joint replacement, it is from 36 to 110 months. Measures like Government subsidisation programme for the replacement surgery and employing adequate physiotherapists, Chinese medicine practitioners, clinical psychologists and nurses to reduce the waiting time are suggested. Issues concerning the healthcare system of Hong Kong, such as structural reform, service delivery model, primary care, quality and process management, and policy reviews, are also discussed.

The ‬over-reliance of public services has resulted in long waiting time in public hospitals in Hong Kong, particularly in the emergency services and SOP clinics. However, the consequences of long waiting period for surgical operations, though much less discussed by the media and public, can be potentially detrimental to the patients and families, and may result in more burdens to the already stretched public hospitals‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬.

In North America, delegated practice “medical direction” models are often used as a proxy for clinical quality and safety in paramedic services. Other developed countries favor a combination of professional regulatory boards and clinical governance frameworks that feature paramedics taking lead clinician roles. The purpose of this paper is to bring together the evidence for medical direction and clinical governance in paramedic services through the prism of paramedic self-regulation.

This narrative synthesis critically examines the long-established North American Emergency Medical Services medical direction model and makes some comparisons with the UK inspired clinical governance approaches that are used to monitor and manage the quality and safety in several other Anglo-American paramedic services. The databases searched were CINAHL and Medline, with Google Scholar used to capture further publications.

Synthesis of the peer-reviewed literature found little high quality evidence supporting the effectiveness of medical direction. The literature on clinical governance within paramedic services described a systems approach with shared responsibility for quality and safety. Contemporary paramedic clinical leadership papers in developed countries focus on paramedic professionalization and the self-regulation of paramedics.

The lack of strong evidence supporting medical direction of the paramedic profession in developed countries challenges the North American model of paramedics practicing as a companion profession to medicine under delegated practice model. This model is inconsistent with the international vision of paramedicine as an autonomous, self-regulated health profession.

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.

The purpose of this study is to describe the design and validation of a three-dimensional (3D)-printed phantom of a uterus to support the development of uterine balloon tamponade devices conceived to stop post-partum haemorrhages (PPHs).

The phantom 3D model is generated by analysing the main requirements for validating uterine balloon tamponade devices. A modular approach is implemented to guarantee that the phantom allows testing these devices under multiple working conditions. Once finalised the design, the phantom effectiveness is validated experimentally.

The modular phantom allows performing the required measurements for testing the performance of devices designed to stop PPH.

PPH is the leading obstetric cause of maternal death worldwide, mainly in low- and middle-income countries. The proposed phantom could speed up and optimise the design and validation of devices for PPH treatment, reducing the maternal mortality ratio.

To the best of the authors’ knowledge, the 3D-printed phantom represents the first example of a modular, flexible and transparent uterus model. It can be used to validate and perform usability tests of medical devices.