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The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.

The methodology entails the integration of service design (SD) and action research (AR) methodologies, characterized by iterative phases that systematically alternate between action and reflective processes, fostering cycles of change and learning. Within this framework, stakeholders are engaged through semi-structured interviews, while the existing and envisioned processes are delineated and represented using BPMN 2.0. These methodological steps emphasize the development of an autonomous, patient-centric web application alongside the implementation of an adaptable and patient-oriented scheduling system. Also, business processes simulation is employed to measure key performance indicators of processes and test for potential improvements. This method is implemented in the context of the CP addressing transient loss of consciousness (TLOC), within a publicly funded hospital setting.

The methodology integrating SD and AR enables the detection of pivotal bottlenecks within diagnostic CPs and proposes optimal corrective measures to ensure uninterrupted patient care, all the while advancing the digitalization of diagnostic CP management. This study contributes to theoretical discussions by emphasizing the criticality of process optimization, the transformative potential of digitalization in healthcare and the paramount importance of user-centric design principles, and offers valuable insights into healthcare management implications.

The study’s relevance lies in its ability to enhance healthcare practices without necessitating disruptive and resource-intensive process overhauls. This pragmatic approach aligns with the imperative for healthcare organizations to improve their operations efficiently and cost-effectively, making the study’s findings relevant.

This study aims to analyse the structure of the Indian vaccine supply chain (SC) during the Covid-19 crisis and explore the underlying challenges at each stage in the network. It also brings out the difference in performance of various constituent states.

This study relied on both primary and secondary data for the analyses. For the primary data, the study gathered experts’ opinions to validate the authors’ inferences. For the secondary data, it relies on government data provided in websites.

Based on the quartile analysis and cluster analysis of the secondary data, the authors find that the constituent states responded differently during the first and second waves. This was due to the differences in SC characteristics attributed to varied demographics and administrative efficiency.

This paper’s analyses is primarily limited to secondary information and inferences are based on them. The study has important implications for implementing the large-scale vaccination drives by government and constituent states for better coordination and last-mile delivery.

The contribution is unique in studying the performance of constituent states using statistical techniques, with secondary data from authentic sources. It is also unique in combining this observation with validation from experts.

The main purpose of this paper is to explore whether the nature of innovation is accumulative or radical and to what extent past year accumulation of technology stock can predict future innovation. More importantly, the authors are concerned with whether a change of policy regime or a variance in the quality of technology will moderate the nature of innovation.

The authors examined a dataset of 3.6 million Chinese patents during 1985–2015 and constructed more than 5 million citation pairs across 8 sections and 128 classes to track knowledge spillover across technology fields. The authors used this citation dataset to calculate the technology innovation network. The authors constructed a measure of upstream invention, interacting the pre-existing technology innovation network with historical patent growth in each technology field, and estimated measure's impact on future innovation since 2005. The authors also constructed three sets of metrics – technology dependence, centrality and scientific value – to identify innovation quality and a policy dummy to consider the impact of policy on innovation.

Innovation growth is built upon past year accumulation and technology spillover. Innovation grows faster for technologies that are more central and grows more slowly for more valuable technologies. A pro-innovation and pro-intellectual property right (IPR) policy plays a positive and significant role in driving technical progress. The authors also found that for technologies that have faster access to new information or larger power to control knowledge flow, the upstream and downstream innovation linkage is stronger. However, this linkage is weaker for technologies that are more novel or general. On most occasions, the nature of innovation was less responsive to policy shock.

This paper contributes to the debate on the nature of innovation by determining whether upstream innovation has strong predictive power on future innovation. The authors develop the assumption used in the technology spillover literature by considering a time-variant, directional and asymmetric matrix to model technology diffusion. For the first time, the authors answer how the nature of innovation will vary depending on the technology network configurations and policy environment. In addition to contributing to the academic debate, the authors' study has important implications for economic growth and industrial or innovation management policies.

Decentralization has profound implications for many health systems. This study investigates the effect of health system decentralization in Organization for Economic Co-operation and Development (OECD) countries on public health security capacity and health service satisfaction.

Multiple linear regression analyses were employed for variables related to the level of health security capacity and satisfaction with the healthcare system while controlling for all socio-demographic variables from the European Social Survey, including over 44,000 respondents from 25 OECD countries. The Health Systems in Transition series of countries were used for assessing the decentralization level.

The result of multiple linear regression analyses showed that the level of decentralization in health systems was significantly associated with higher health security capacity (ß-coefficient 3.722, 95% confidence interval (CI) [3.536 3.908]; p=<0.001) and health service satisfaction (ß-coefficient 1.463, 95% CI [1.389 1.536]; p=<0.001) in the study. Countries with a higher level of decentralization in health policy tasks and areas were significantly likely to have higher health services satisfaction, whereas this satisfaction had a significant negative relation with the lower level of decentralization status of secondary/tertiary care services in OECD countries (ß-coefficient −5.250, 95% CI [−5.757–4.743]; p = 0.001).

This study contributes to a better understanding of the extent to which decentralization of health services affects public health safety capacity and satisfaction with health services, whereas the level of decentralization in OECD countries varies considerably. Overall, the findings highlight the importance of public health security and satisfaction with health care delivery in assessing the effects of decentralization in health services.

This study aims to examine why tax reforms fail and explores how tax collection can be improved within a developing country context.

Data comprise 28 semi-structured interviews with taxpayers, tax experts and tax authority personnel based in Pakistan. The results are analysed using a combined lens of taxpayer trust and tax agencies’ capabilities.

Tax reforms failed to build taxpayers’ trust and tax agencies’ capabilities. Building trust is challenging and demands extensive ongoing engagement with taxpayers while yielding gradual permanent results. This requires enhancing confidence in government; educating taxpayers; removing complexities; introducing transparency and accountability in tax agencies’ operations and the tax system; promoting procedural and distributive justice; and reversing perceptions of corruption through reconciliation and stakeholder inclusivity. Developing tax agencies’ capabilities requires upgrading outdated technologies, systems and processes; implementing governance and organisational reforms; introducing an oversight board; and recruiting and training skilled professionals.

The findings can assist policymakers and tax collection authorities in understanding why tax reforms fail and identifying potential solutions.

This study contributes to the emerging literature by exploring tax administration failures in developing countries. It contributes to the literature by engaging stakeholders to understand why reforms fail and potential solutions to stimulate tax revenues.

The aim of this study is to empirically explore and analyze the concrete tasks of output measurement and the inherent challenges related to these tasks in a traditional and autonomous professional public work setting – the judicial system.

The analysis of the tasks is based on a categorization of general performance measurement motives (control-motivate-learn) and main stakeholder levels (society-organization-professionals). The analysis is exploratory and conducted as an empirical content analysis on materials and reports produced in two performance improvement projects conducted in European justice organizations.

The identified main tasks in the different categories are related to managing resources, controlling performance deviations, and encouraging improvement and development of performance. Based on the results, key improvement areas connected to output measurement in professional public organizations are connected to the improvement of objectivity and fairness in budgeting and work allocation practices, improvement of output measures' versatility and informativeness to highlight motivational and learning purposes, improvement of professional self-management in setting output targets and producing outputs, as well as improvement of organizational learning from the output measurement.

The paper presents empirically founded practical examples of challenges and improvement opportunities related to the tasks of output measurement in professional public organization.

This paper fulfils an identified need to study how general performance management motives realize as concrete tasks of output measurement in justice organizations.

This study aims to construct a mental health service system for middle school students in the post-COVID-19 era with the framework of Six Sigma DMAIC (define, measure, analyze, improve and control) and analyze the influencing factors of the mental health service system to study the implementation strategies of quality-oriented mental health services in middle schools.

This study was conducted in Tianjin, China, from September to November 2022, and 350 middle school students from Tianjin Public Middle School were selected as subjects. A questionnaire survey was used to collect data. In this study, the Six Sigma DMAIC method, sensitivity analysis method, exploratory factor analysis and principal component analysis were used to analyze the mental health services provided to middle school students.

Based on the Six Sigma DMAIC framework, this study indicates that the contribution rate of the mental health service process factor is the largest in the post-COVID-19 era. The mental health cultivation factor ranks second in terms of its contribution. Mental health quality and policy factors are also important in the construction of middle school students’ mental health service system. In addition, the study highlights the importance of parental involvement and social support in student mental health services during the post-COVID-19 era.

To the best of the authors’ knowledge, a study on middle school students’ mental health in the post-Covid-19 era has not yet been conducted. This study developed a quality-oriented mental health system and analyzed the influencing factors of mental health for middle school students based on data analysis and the Six Sigma DMAIC method.

The purpose of this article is to show (1) how social innovations are created through co-production in social enterprises in Finland and (2) how enabling ecosystems for the creation of social innovations can be enhanced by the government.

This study is a descriptive case study. The data comprises focus group interviews that were conducted during a research project in Finland in 2022. The interviewees represented different social enterprises, other non-profit organisations and national funding institutions.

Social enterprises create social innovations in Finland through co-production, where service innovation processes, activism and networking are central. Also, to build an enabling ecosystem, government must base the system upon certain elements: enabling characteristics of the stakeholders, co-production methods and tools and initiatives by the government.

The authors address an important challenge that social enterprises struggle with: The position of social enterprises in Finland is weak and entrepreneurs experience prejudice from both the direction of “traditional” businesses and the government which often does not recognise social enterprise as a potential partner for public service delivery. Nonetheless, social enterprises create public value by contributing to the co-production of public services. They work in interorganisational networks by nature and can succeed where the traditional public organisations and private businesses fail.

By increasing the digitalization of commercial services citizens' expect more from public services. First of all, this study will strive to identify which problems citizens encounter when they use a complex public service: preparation of an application for a building permit. In the light of the popularity of omnichannel approaches, the study then explores how omni-channel could help to address the problems which have been identified.

We implement the first phases of an action design science research project. We collect data both from citizens and public agencies and frame them as transparency problems. These abstract problems are then addressed by an omnichannel service provision as an abstract solution. The abstract solution is then instantiated in a design in the form of a user scenario developed in collaboration with current and future public officials.

The analysis uncovers multiple transparency issues: it distinguishes between process, case, language, cross-channel and cost transparency. One root cause of the transparency issues observed is the lack of service transparency which defines the purpose and scope of a ser-vice. We therefore recommend defining a service-strategy before informational and technical aspects of an omnichannel approach can be implemented. Following this strategy, omnichannel offers public administrations unique opportunities to excel in citizens' service provision.

The study provides insights into how citizens view complex public services. For researchers, this study offers the conceptualization as transparency issues. Practitioners from the public administrations can also benefit from the concept and vision of omnichannel public services.

This article aims to explore the concept of chain value of the public port system in Ecuador from the perspective of importing/exporting companies, analyzing how perceived value in the use of port services affects customer satisfaction and the intermediate links of the influence of trust and commitment on customer loyalty.

Relying on a survey of 634 Ecuadorian companies with experience in international trade as port users and a theoretical framework well-established in the literature on consumer behavior, the empirical study found evidence of a positive and significant relationship with the knowledge of chain effects.

The findings confirm the chain effect and reveal ways to maintain an ongoing satisfactory, trust and committed relationship with users, thereby ultimately gaining and maintaining their loyalty. The conclusions suggest how this postulate can help to close the gap referred to the effective management of port services, and point out that port managers should be concerned with a continuous in-depth understanding of the perceived value and its chain effects.

The authors add evidence of the use of the postulate of the chain of effects on these dimensions, whose applicability is very well established, tested and consensual for the doctrine in industrial marketing. In contrast, it is scarcely present in the port relationship with its users.