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The paper aims to investigate the practices facilitating the transformation of healthcare services, understanding the resulting outcomes in terms of well-being and uplifting changes. a systematic literature review (SLR) focusing on analyzing the healthcare sector under the transformative service research (TSR) theoretical domain is conducted to achieve this goal.

Employing a structured SLR developed based on the PRISMA protocol (Pickering and Byrne, 2014; Pickering et al., 2015) and using Scopus and WoS databases, the study identifies and analyzes 49 papers published between 2021 and 2022. Content analysis is used to classify and analyze the papers.

The SLR reveals four transformative practices (how) within the healthcare sector under the TSR domain, each linked to specific well-being outcomes (what). The analysis shows that both practices and outcomes are mainly patient-related. An integrative framework for transformative healthcare service is presented and critically examined to identify research gaps and define the trajectory for the future development of TSR in healthcare. In addition, managerial implications are provided to guide practitioners.

This research is among the first to analyze TSR literature in the context of healthcare. The study critically examines the TSR’s impact on the sector’s transformation, providing insights for future research and offering a roadmap for healthcare practitioners to facilitate uplifting changes.

A new triage method, MBCE (Medical Bio Social Ethics), is presented with social justice, bio, and medical ethics for critical resource distribution during a pandemic. Ethical triage is a complex and challenging process that requires careful consideration of medical, social, cultural, and ethical factors to guide the decision-making process and ensure fair and transparent allocation of resources. When assigning priorities to patients, a clinician would evaluate each patient’s medical condition, age, comorbidities, and prognosis, as well as their cultural and social background and ethical factors.

A statistical analysis shows no interactions among the ethical triage factors. It implies the ethical components have no moderation effect; hence, each is independent. The result also points out that medical and bioethics may have an affinity for interactions. In such cases, there seem to be some ethical factors related to bio and medical ethics that are correlated. Therefore, the triage team should be careful in evaluating patient cases. The algorithm is explained with case histories of the selected patient. A group of triage nurses and general medical practitioners assists with the triage.

The MBCE triage algorithm aims to allocate scarce resources fairly and equitably. Another ethical principle in this triage algorithm is the principle of utility. In a pandemic, the principle of utility may require prioritizing patients with a higher likelihood of survival or requiring less medical care. The research presents a sensitivity analysis of a patient’s triage score to show the algorithm’s robustness. A weighted score of ethical factors combined with an assessment of triage factors combines multiple objectives to assign a fair triage score. These distinctive features of the algorithm are reasonably easy to implement and a new direction for the unbiased triage principle.

The idea is to make decisions about distributing and using scarce medical resources. Triage algorithms raise ethical issues, such as discrimination and justice, guiding medical ethics in treating patients with terminal diseases or comorbidity. One of the main ethical principles in triage algorithms is the principle of distributive justice.

This study aims to evaluate how a community psychiatry model, referred to as the Mental Health Action Trust (MHAT) in India, provides decentralized care and comprehensive services to people with severe mental illness living in poverty. Using the complex adaptive system (CAS) framework, the authors aim to understand the factors that contribute to the diverse outcomes of the MHAT community mental health programme as observed in four different locations.

Four MHAT clinics were purposively chosen from two districts in Kerala. A comparative case study methodology was used to document each clinic’s MHAT services and activities, as found during field visits and interviews with staff members and volunteers.

The study shows that all four clinics met the basic aim of providing free, quality mental health care to the poorest populations, although not all aspects of the comprehensive model could be equally provided. Alignment with the MHAT vision, appropriate leadership, the relationship with partners and their level of community engagement determined the varied success between clinics.

The current study evaluation stresses that community ownership is crucial. Careful attention must be paid to the characteristics of selected partners, including their leadership styles and ability to garner resources.

This paper aims to “identify,” “analyse” and “categorise” the readiness factors of lean sustainability in health-care organisation using total interpretive structural modelling (TISM).

To obtain the data, a closed-ended questionnaire was used in addition to a scheduled interview. To identify how the factors interact, the TISM approach was used, and the matriced’ impacts croise’s multiplication applique’e a UN classement (MICMAC) analysis was used to rank and categorise the lean sustainability readiness factors.

This study identified ten lean sustainability readiness factors for health-care organisation. The identified factors are resources utilization practice (F1), management commitment and leadership (F2), operational flexibility (F3), workforce engagement and time commitment (F4), sustainability motivational factors (F5), awareness of lean and sustainable practice (F6), hospital design (F7), energy efficiency practices in hospitals (F8), responsible autonomy (F9) and new system adoptability training (F10). The key/driving factors are identified in this study are operational flexibility, sustainability motivational factors, management commitment and leadership, new system adoptability training.

The study focussed primarily on lean sustainability factors for the health-care sector.

This research will aid key stakeholders and academics in the better understanding the readiness factors that influence lean sustainability in health-care organisation. This study emphasises the factors that must be considered when applying lean sustainable practices in health care as a real-world application in a health-care organisation. These readiness factors for lean sustainability can be used by an organization to comprehend more about the concept and the components that contribute to health-care lean sustainability.

This study proposes the TISM technique for health care, which is a novel attempt in the subject of lean sustainability in this sector.

This study aims to facilitate access to vascular disease screening for low-income individuals living in remote and conflict areas based on the results of a pilot trial in Colombia. Also, to increase the amount of diagnosis training of vascular surgery (VS) in civilians.

The operation method includes five stages: strategy development and adjustment; translation of the strategy into a real-world setting; operation logistics planning; strategy analysis and adoption. The operation plan worked efficiently in this study’s sample. It demonstrated high sensibility, efficiency and safety in a real-world setting.

The authors developed and implemented a flow model operating plan for screening vascular pathologies in low-income patients pro bono without proper access to vascular health care. A total of 140 patients from rural areas in Colombia were recruited to a controlled screening session where they underwent serial noninvasive ultrasound assessments conducted by health professionals of different training stages in VS.

The plan was designed to be implemented in remote, conflict areas with limited access to VS care. Vascular injuries are critically important and common among civilians and military forces in regions with active armed conflicts. As this strategy can be modified and adapted to different medical specialties and geographic areas, the authors recommend checking the related legislation and legal aspects of the intended areas where we will implement this tool.

Different sub-specialties can implement the described method to be translated into significant areas of medicine, as the authors can adjust the deployment and execution for the assessment in peripheral areas, conflict zones and other public health crises that require a faster response. This is necessary, as the amount of training to which VS trainees are exposed is low. A simulated exercise offers a novel opportunity to enhance their current diagnostic skills using ultrasound in a controlled environment.

Evaluating and assessing patients with limited access to vascular medicine and other specialties can decrease the burden of vascular disease and related complications and increase the number of treatments available for remote communities.

It is essential to assess the most significant number of patients and treat them according to their triage designation. This management is similar to assessment in remote areas without access to a proper VS consult. The authors were able to determine, classify and redirect to therapeutic interventions the patients with positive findings in remote areas with a fast deployment methodology in VS.

Access to health care is limited due to multiple barriers and the assessment and response, especially in peripheral areas that require a highly skilled team of medical professionals and related equipment. The authors tested a novel mobile assessment tool for remote and conflict areas in a rural zone of Colombia.

Advancing behavioral health and primary care integration is a priority for helping clients overcome the complex health challenges impacting healthcare deserts like those in Arizona, United States of America (USA). This study aimed to explore the perspectives of people with a substance use disorder (SUD) on accessing integrated primary care (IPC) services in a rural-serving behavioral healthcare organization in Arizona.

Clients from a behavioral health facility in Arizona (n = 10) diagnosed with SUDs who also accessed IPC participated in a 45-min semi-structured interview.

The authors identified six overarching themes: (1) importance of IPC for clients being treated for SUDs, (2) client low level of awareness of IPC availability at the facility, (3) strategies to increase awareness of IPC availability at the behavioral health facility, (4) cultural practices providers should consider in care integration, (5) attitudes and perceptions about the experience of accessing IPC and (6) challenges to attending IPC appointments. The authors also identified subthemes for most of the main themes.

This is the first study in rural Arizona to identify valuable insights into the experiences of people with SUDs accessing IPC, providing a foundation for future research in the region on care integration.

This study aims to investigate how institutional and organisational factors affect case management of patients with mental disorders by GPs in Italy and Spain. The paper highlights the importance of improving the effectiveness of primary care to ensure easy access to mental health services, which is crucial in responding to the increasing incidence of mental disorders and preventing negative outcomes.

This article details a qualitative research study that examines the management of patients with mental disorders by general practitioners (GPs) in Italy and Spain, using cross-national comparison and in-depth interviews with GPs as research methods.

The study revealed that Italian self-employed GPs have more scheduling autonomy than Spanish Health Centre GPs. Both face high work pressure and resource scarcity, highlighting the need for targeted training. The COVID-19 pandemic led to a rise in phone consultations.

This study provides novel insights into mental health management by examining the case management of patients with mental disorders by GPs in Italy and Spain, with a focus on the impact of institutional and organisational factors. The cross-national comparison and in-depth interviews enhance the originality of the study, offering a nuanced understanding of the constraints faced by GPs in their work context. Furthermore, the comparison of the similar primary care frameworks of Italy and Spain may offer insight into their evolution.

Evidence of overprescribing of psychotropic medicines to manage challenging behaviour in people with intellectual disabilities has led to national programmes within the UK to promote deprescribing, such as stopping the overprescribing of medication in people (with learning disabilities, autism or both). To successfully implement deprescribing initiatives, we need to understand how to engage stakeholders in the process.

In a published systematic review, we reported evidence about the process of deprescribing psychotropic medicines for people of all ages with intellectual disabilities and challenging behaviour. As a part of the original review, we searched for evidence about stakeholders’ experiences of the psychotropic deprescribing process, which was synthesised and reported within the current study.

Six studies were identified. Involving carers and people with intellectual disabilities, providing ongoing support and improving access to non-pharmacological interventions, including positive behaviour support, may contribute to successful outcomes, including reducing or stopping psychotropic medicines and improving quality of life. Implementing psychotropic deprescribing requires a multidisciplinary collaborative care approach and education for stakeholders.

There have been no previous reviews of stakeholder experiences of deprescribing psychotropic medications for people with intellectual disabilities and challenging behaviour. The existing literature is scant, and further research is needed.

The primary aim of this research was to investigate the mediating effect of the decision-making structure on the relationship between perceived environmental uncertainty and hospital performance.

Online and manual survey questionnaires were used to collect data in this study. The target population of this study consists of all middle managers within 11 COVID-19 referral hospitals in Surabaya. A total of 189 responses were collected, however, 27 incomplete responses were excluded from the final dataset. Data was analyzed using SEM-PLS.

The study's findings indicate that decision-making structure plays a role in mediating the link between perceived environmental uncertainty and hospital performance assessed via the Balanced Scorecard, highlighting the significance of flexible decision-making processes during uncertain periods. Moreover, based on our supplementary test, respondents' demographic characteristics influence their perceptions of hospital performance.

Hospital administrators can consider the significance of decision-making structures in responding to environmental uncertainties like the COVID-19 pandemic. By fostering adaptable decision-making processes and empowering middle managers, hospitals may enhance their performance and resilience in challenging situations. Additionally, based on supplementary tests, it is found that differences in the perception of the three Balanced Scorecard perspectives imply that hospitals categorized as types A, B, C, and D should prioritize specific areas to improve their overall performance.

This research adds substantial originality and value to the existing body of knowledge by exploring the interplay between decision-making structures, environmental uncertainty, and hospital performance. It contributes to the literature by specifically focusing on the Covid-19 pandemic, a unique and unprecedented global crisis.

As public health professionals strive to promote vaccines for inoculation efforts, fervent anti-vaccination movements are marshaling against it. This study is motived by a need to better understand the online discussion around vaccination. The authors identified the sentiments, emotions and topics of pro- and anti-vaxxers’ tweets, investigated their change since the pandemic started and further examined the associations between these content features and audiences’ engagement.

Utilizing a snowball sampling method, data were collected from the Twitter accounts of 100 pro-vaxxers (266,680 tweets) and 100 anti-vaxxers (248,425 tweets). The authors are adopting a zero-shot machine learning algorithm with a pre-trained transformer-based model for sentiment analysis and structural topic modeling to extract the topics. And the authors use the hurdle negative binomial model to test the relationships among sentiment/emotion, topics and engagement.

In general, pro-vaxxers used more positive tones and more emotions of joy in their tweets, while anti-vaxxers utilized more negative terms. The cues of sadness predominantly encourage retweets across the pro- and anti-vaccine corpus, while tweets amplifying the emotion of surprise are more attention-grabbing and getting more likes. Topic modeling of tweets yields the top 15 topics for pro- and anti-vaxxers separately. Among the pro-vaxxers’ tweets, the topics of “Child protection” and “COVID-19 situation” are positively predicting audiences’ engagement. For anti-vaxxers, the topics of “Supporting Trump,” “Injured children,” “COVID-19 situation,” “Media propaganda” and “Community building” are more appealing to audiences.

This study utilizes social media data and a state-of-art machine learning algorithm to generate insights into the development of emotionally appealing content and effective vaccine promotion strategies while combating coronavirus disease 2019 and moving toward a global recovery.

The peer review history for this article is available at https://publons.com/publon/10.1108/OIR-03-2022-0186