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This paper aims to examine whether medical tourism can be a frontrunner in terms of post-pandemic recovery for the industry

A mixed-method analysis of 17 interviews and 210 questionnaires involving medical tourists to Iran was applied.

Medical tourists perceived the risks posed by COVID-19 as a temporal one, and attitudes toward post pandemic visitation intentions remained strong. In addition, these tourists can mostly be classified into responsive individuals, who demonstrate not only high risk but also high efficacy levels to negotiate the threats posed by the pandemic. No gender differences were located between male and female medical tourists in terms of post-COVID-19 travel intentions to Iran.

This research extends the application of the risk perception attitude framework to a medical tourism context. Furthermore, medical tourists are uncovered as another segment of crisis-resistant tourists.

The purpose of this paper is to identify the factors influencing the visit intention of medical tourists to India. This study also attempts to extend the theory of planned behaviour through the integration of perceived risk and facilitating condition.

Primary data were collected from a sample of 326 medical tourists arriving in India through Terminal-3 of Indira Gandhi International Airport (IGI-T3), New Delhi, India, during the months of October–December 2019. Confirmatory factor analysis and structural equation modelling are deployed to analyze the collected data and validate the proposed research model.

The outputs of this study revealed that perceived financial risk, physical risk, psychological risk and facilitating conditions available in a country are significantly linked to the attitude of a medical tourist. Similarly, facilitating conditions available in a country are significantly related to perceived behavioural control of a medical tourist. Furthermore, it is also revealed that attitude, subjective norm and perceived behavioural control are significantly related to visit intention of medical tourists to India; however, the perceived time risk and performance risk are insignificantly associated with the visit intention.

This study is restricted to the opinion of 326 sample respondents consisting of medical tourists who arrived in India through IGI-T3, New Delhi, during October–December 2019. In the future, a similar type of study may be conducted in different parts of the country with a relatively larger sample size

This study addresses the need for advancing the knowledge on the factors in determining visit intention of medical tourists towards India. This knowledge will become very crucial for India's medical tourism industry, which is aiming to attain a competitive edge in the global market.

The purpose of this paper is to describe the relationship between job stress, stress coping ability and performance among Japanese nurses.

Health risk and organization environment as job stress factors, sense of coherence (SOC) as stress coping ability and medical risk indicator and sickness‐absence days as a performance proxy were used to investigate the relationship between stress and performance. Length of professional experience also was included in the investigation.

The findings suggest a possibility that enriching nurses' professional experiences reduces medical risk. There is also a possibility that raising the SOC, while improving organization environment, contributes to reducing sickness‐absence.

A cross‐sectional study of nurses in a single institution was used. In order to generalize the study's results, it will be necessary to conduct multi‐institutional longitudinal studies.

The present study shows key factors affecting medical risk and sickness‐absence leading to a reduced nursing performance.

Medical technologies and assets are one of the main drivers of increasing healthcare cost. The rising number and complexity of medical equipment have forced hospitals to set up and regulate medical equipment management programs to ensure critical devices are safe and reliable. The purpose of this paper is to gain insights into maintenance management-related activities for medical equipment. The paper proposes applying a tailored reliability-centered maintenance (RCM) approach for maintenance activities selection for medical equipment. Such approach will support assets management teams in enhancing operation, decrease risk and cost, and ultimately improve health of patients served by these equipment.

The traditional RCM approach will be used with a focus on criticality reduction. By criticality, the authors refer to the severity of failures and occurrence. The proposed method relies on the use of reliability growth analysis for opportunity identification followed by a thorough failure mode and effect analysis to investigate major failure modes and propose ways to reduce criticality. The effectiveness of the proposed method will be demonstrated using a case of one of the leading obstetric and gynecological hospitals in United Arab Emirates and in the Gulf Cooperation Council region.

The case examines the relationship between the current practice of planned preventive maintenance and the failure rates of the equipment during its life span. Although a rigorous preventive maintenance program is implemented in the hospital under study, some critical equipment show an increasing failure rates. The analysis highlights the inability of traditional time-driven preventive maintenance alone in preventing failures. Thus, a systematic RCM approach focused on criticality is more beneficial and more time and cost effective than traditional time-driven preventive maintenance practices.

The study highlights the need for utilizing RCM approach with criticality as the most important prioritization criterion in healthcare. A proper RCM implementation will decrease criticality and minimize the risk of failure, accidents and possible loss of life. In addition to that, it will increase the availability of equipment, and reduce cost and time.

This paper proposes a maintenance methodology that can help healthcare management to improve availability and decrease the risk of critical medical equipment failures. Current practices in healthcare facilities have difficulty identifying the optimal maintenance strategy. Literature focused on medical maintenance approach selection is rather limited, and this paper will help in this discussion. In addition to that, the Association for the Advancement of Medical Instrumentation supports the initiative of adopting RCM on a large scale in healthcare. Therefore, this paper address the gap in the literature for medical equipment maintenance and the work is in line with the recommendation of leading healthcare association. The paper also presents statistical review of the total number of received maintenance work orders during one full year in the hospital under study. The analysis supports the need for more research to examine current practice and propose more effective maintenance approaches.

Inventory management systems in health-care supply chains (HCSC) have been pushed to breaking point by the COVID-19 pandemic. Unanticipated demand shocks due to stockpiling of medical supplies caused stockouts, and the stockouts triggered systematic supply chain (SC) disruptions inconceivable for risk managers working individually with limited information about the pandemic. The purpose of this paper is to respond to calls from the United Nations (UN) and World Health Organization (WHO) for coordinated global action by proposing a research agenda based on a review of current knowledge and knowledge gaps on the role of collaboration in HCSCs in maintaining optimal stock levels and reinforcing resilience against stockout disruptions during pandemics.

A systematic review was conducted, and a total of 752 articles were analyzed.

Collaborative planning, forecasting and replenishment practices are under-researched in the HCSC literature. Similarly, a fragmented application of extant SC collaborative risk management capabilities undermines efforts to enhance resilience against systematic disruptions from medical stockouts. The paucity of HCSC articles in humanitarian logistics and SC journals indicates a need for more research interlinking two interdependent yet critical fields in responding to pandemics.

Although based on an exhaustive search of academic articles addressing HCSCs, there is a possibility of having overlooked other studies due to search variations in language controls, differences in publication cycle time and database search engines.

The paper relies on COVID-19's uniqueness to highlight the limitations in optimization and individualistic approaches to managing medical inventory and stockout risks in HCSCs. The paper proposes a shift from a fragmented to holistic application of relevant collaboration practices and capabilities to enhance the resilience of HCSCs against stockout ripple effects during future pandemics. The study propositions and suggestion for an SC learning curve provide an interdisciplinary research agenda to trigger early preparation of a coordinated HCSC and humanitarian logistics response to future pandemics.

The purpose of this paper is to provide an understanding on implementation and operation of ISO 13485:2003 – “Medical Devices – Quality Management System – Requirements for Regulatory Purposes” – in the perspective of medical device industries in Malaysia. The study is focused on the Malaysian Small and Medium Enterprises (SMEs) which currently have accredited to ISO 9001:2000 quality management systems.

Literature research and comparative analysis between ISO 13485:2003 and ISO 9001:2000 standard and requirements. A reference model is developed to assist the Malaysian SMEs towards ISO 13485:2003 accreditation.

Unlike ISO 9001:2000, ISO 13485:2003 stresses the safety and efficacy of medical devices that are being produced. For this reason risk management is an essential process that needs to be adopted into the ISO 13485:2003 quality management system. Moreover, to demonstrate the effectiveness of the ISO 13485:2003 implementation, this standard has placed great emphasis on documentation requirements which are more prescriptive in insisting on the use of formal procedures.

The paper provides guidelines to ISO 13485:2003 implementations as well as risk management approaches for small and medium‐sized businesses of Malaysian medical device manufacturers, which at the same time maintains its ISO 9001:2000 certification.

The identification of the main risk triggers is essential for the hospital’s survival and performance with direct effects on its patients’ health and well-being. For this reason, in this paper some of the most important risk categories have been determined. While in a previous research a qualitative analysis has been done for determining which are the most important risks felt by the patient that are believed to affect their health through the usage of a questionnaire and through conducting a confirmatory factor analysis, the purpose of this paper is to analyze the quantitative side of these risks’ presence in a hospital.

On this purpose, four main categories of risks have been considered (the same as in the qualitative research) and they have been analyzed from the hospital’s point of view – through the usage of the hospital financial and internal documents. Therefore, a series of indicators have been determined for each risk category. After that, a representative indicator has been selected and the grey incidence analysis has been conducted.

By comparing the results gathered form this study with the qualitative analysis conducted among the patients (Delcea et al., 2016) it can be said that there can be seen a difference among the way a hospital and a patient perceive the risks within a medical activity. While for the hospital, the most affecting risk is the technological and hospital conditions risk, for the patients the most affecting risk seems to be the human resources and clinical risk. The mismanagement risk and inability to treat patients is the second in intensity for both the hospital and patients, with a smaller value in the patients’ case.

From here, the research can be extended for capturing the risks that are considered to be important for the medical stuff, which will permit us to have a global image over the healthcare risks. After that, a comparative analysis among the hospitals with different financial performance can be conducted in order to see how these risks are affecting their performance and to determine which can be the decisions that can fostering the reduction of these risks.

The present paper offers a quantitative analysis from the hospital’s point of view using the advantages offered by the grey systems theory. Combining this analysis with a qualitative one conducted on the patients, the managers of the hospital can a have a more adequate view over the risks that they are facing with. In this context, grey systems theory offers the needed methods for dealing with such situations.

The purpose of this paper is to report on use of the IEC80001 standard, Application of Risk Management for Information Technolody (IT) Networks Incorporating Medical Devices, to deploy a wireless alarm management solution in a long-term care home facility.

The standard suggests the use of a unique responsibility matrix and a continuous quality improvement approach for analysis, evaluation and control of risks. A unique leadership committee and workgroup were formed to develop processes and procedures for integrating medical devices with IT systems; as well as execution of the project itself. The leadership committee oversaw the phased approach of assessing the technology, the clinical environment, proponent technology-based solutions and a specified risk management file. The project expanded its scope beyond the standard to include a risk focussed analysis of clinical workflow to evaluate the usability of the solution.

The standard focussed approach identified numerous risks associated with the technical and network solution and the future state workflow. Medical devices proved to be the most limiting technology needing to be incorporated into the solution. Although faced with a daunting list of network related risks, it was concluded that all residual risks would have been acceptable. The analysis of the future state workflow identified various risks related to usability (human factors), battery management and the absence of additional operating dollars for supplementary staffing duties and new operational expenses.

To the best of the authors knowledge, this paper is the first one to detail the process of following the IEC80001 standard in Canada. It offers insight into building an organizational framework around the standard and identifies gaps that should be considered by executive and project sponsors before proceeding with a project.

The purpose of this paper is to describe a study which aimed to develop and validate an assessment method for the International Electrotechnical Commission (IEC) 80001-1 (IEC, 2010) standard (the Standard); raise awareness; improve medical IT-network project risk management processes; and improve intensive care unit patient safety.

An assessment method was developed and piloted. A healthcare IT-network project assessment was undertaken using a semi-structured group interview with risk management stakeholders. Participants provided feedback via a questionnaire. Descriptive statistics and thematic analysis was undertaken.

The assessment method was validated as fit for purpose. Participants agreed (63 per cent, n=7) that assessment questions were clear and easy to understand, and participants agreed (82 per cent, n=9) that the assessment method was appropriate. Participant’s knowledge of the Standard increased and non-compliance was identified. Medical IT-network project strengths, weaknesses, opportunities and threats in the risk management processes were identified.

The study raised awareness of the Standard and enhanced risk management processes that led to improved patient safety. Study participants confirmed they would use the assessment method in future projects.

Findings add to knowledge relating to IEC 80001-1 implementation.

This article aims to describe and analyze the results of efforts to improve patient‐centered care (PCC) in psychiatric healthcare.

Using the methodology of a qualitative case study, the authors studied three Swedish child and adolescent psychiatric care (CAP) units in order to describe how patient‐centered actions are performed. They conducted 62 interviews, made 11 half‐day observations, and shadowed employees for two days.

The article shows that the increased focus on accountability for unit performance and medical risks results in unintended consequences. The patient's medical risk is transformed to a personal risk for the psychiatrist and the resource risk is transformed to a personal risk for the unit manager. Patients become risk objects for both psychiatrists and unit managers, which creates an alignment between them to try to send patients elsewhere. New public management (NPM) reforms may consequently lead to the institutionalization of unintended healthcare practices.

The article shows that accountability pressure to reduce patient risk may create new risks for patients.

The study uses theoretical concepts of risk tradeoffs (risk substitution and risk transformation), which were developed for the macro level, to explain the unintended consequences of NPM reforms at the micro level.