Search results

The purpose of this paper is to conceptualise a research study to examine leadership as a relational concept between leaders and followers. The context is within surgical practice examining how motivated consultant surgeons are to lead junior doctors and which type of leadership style they use. From a follower perspective, the motivation of junior doctors will be explored, and their leadership preferences will be correlated with those of the actual style of consultant surgeons.

In this paper, the authors provide a detailed description of the methods for an international quantitative research study, exploring sequentially how motivated consultant surgeons are to lead and how leadership styles impact on the motivation of junior doctors. The objectives, method and data collection of this study are explained, and the justification for each method is described.

The findings for this outline study illustrate how critical it is to redefine leadership as a relational concept of leader and follower to ensure adequate support is provided to the next generation of consultant surgeons. Without consideration of the relational model of leadership, attrition will continue to be a critical issue in the medical workforce.

The research limitations are that this is a proposed quantitative study due to the need to collect a large sample of data from surgeons across the UK, Egypt and Germany. This research will have immense implications in developing new knowledge of leadership as a relational concept in medicine and healthcare. This study additionally will impact on how leadership is conceptualised in the curriculum for specialist surgical practice.

The practical implications are that relational leadership is supportive of generating a supportive leadership culture in the workplace and generating more effective teamwork.

To the best of the authors’ knowledge, this is the first study of its kind to look at a relational model of leadership in surgical practice between consultant surgeons and surgical trainees. This study will also identify any specific country differences between the UK, Germany and Egypt.

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.

This study aims to examine the applicability of Hartmann et al.’s (2018) service ecosystem framework to the day-to-day management of the modern sales force. The authors provide a review of the framework, acknowledging its strengths, while also indicating areas for advancement. The authors conclude with recommendations to the framework and indicate opportunities where future research could advance sales theory.

A review of the theoretical underpinnings of the service ecosystem framework is weighed against the established roles and responsibilities of the modern sales force in the literature.

The ability of the framework to capture the multi-level, multi-actor and dynamic aspects of sales represents an improvement in the conceptualization of selling is critical. Suggestions around the refinement for meso-level sales interactions and a more pliant application of service dominant-logic are offered.

The suggested extensions of the framework continue the advancement of novel theorization for the field of sales. Priorities for future research include consideration of ethical implications of the framework and formulations of new management strategies reflective of the broad and dynamic properties of the ecosystem conceptualization.

This paper provides managerial guidelines and implications tied specifically to the thick and thin crossing points and how they may impact employee decision-making.

To the best of the authors’ knowledge, this study is the first to pointedly examine the service ecosystem framework with respect to established principles of managing a modern sales force.

Three-dimensional (3D) printing is highly dependent on printing process parameters for achieving high mechanical strength. It is a time-consuming and expensive operation to experiment with different printing settings. The current study aims to propose a regression-based machine learning model to predict the mechanical behavior of ulna bone plates.

The bone plates were formed using fused deposition modeling (FDM) technique, with printing attributes being varied. The machine learning models such as linear regression, AdaBoost regression, gradient boosting regression (GBR), random forest, decision trees and k-nearest neighbors were trained for predicting tensile strength and flexural strength. Model performance was assessed using root mean square error (RMSE), coefficient of determination (R²) and mean absolute error (MAE).

Traditional experimentation with various settings is both time-consuming and expensive, emphasizing the need for alternative approaches. Among the models tested, GBR model demonstrated the best performance in predicting both tensile and flexural strength and achieved the lowest RMSE, highest R2 and lowest MAE, which are 1.4778 ± 0.4336 MPa, 0.9213 ± 0.0589 and 1.2555 ± 0.3799 MPa, respectively, and 3.0337 ± 0.3725 MPa, 0.9269 ± 0.0293 and 2.3815 ± 0.2915 MPa, respectively. The findings open up opportunities for doctors and surgeons to use GBR as a reliable tool for fabricating patient-specific bone plates, without the need for extensive trial experiments.

The current study is limited to the usage of a few models. Other machine learning-based models can be used for prediction-based study.

This study uses machine learning to predict the mechanical properties of FDM-based distal ulna bone plate, replacing traditional design of experiments methods with machine learning to streamline the production of orthopedic implants. It helps medical professionals, such as physicians and surgeons, make informed decisions when fabricating customized bone plates for their patients while reducing the need for time-consuming experimentation, thereby addressing a common limitation of 3D printing medical implants.

In Japan, health-care systems have long been supported by physicians' long working hours. To solve this problem, there is an urgent need to improve the working environment for physicians while practicing patient-centered medicine and controlling health-care costs. This paper aims to examine the effect of task shifting to nurses and discuss its usefulness from the perspective of health-care value co-creation.

This paper analyzes task shifting to nurses in acute care hospitals in Japan as a solution for the shortage of anesthesiologists. The authors discuss how the value was created from the perspective of the health-care ecosystem, with conceptual consideration of the value co-creation mechanism through patient-centered practices.

The study showed that task shifting initiatives in Japan can improve the motivation of nurses through human resource development while maintaining high quality. The study also suggested that task shifting from physicians to nurses may contribute to improving net income and maintaining the health-care system.

The findings are highly reproducible and can be immediately applied to initiatives at other medical institutions in Japan. Furthermore, it is suggested that these findings might provide some perspective on the realignment of fragmented healthcare in the USA.

It was confirmed in practical terms that micro-level initiatives have an impact on the macro level as well. In addition, the academic presentation of the concept has contributed to the deepening of value research.

This study aims to investigate how trauma team members perceive technological equipment and tools in the trauma room (TR) environment and to identify how the technological equipment could be optimized in relation to the TR’s space.

A total of 21 focus group sessions were conducted with 69 trauma team members, all of whom worked in Level I TRs from six teaching hospitals in the USA.

The collected data was analyzed and categorized into three parent themes: imaging equipment, assistive devices and room features. The results of the study suggest that trauma team members place high importance on the availability and versatility of the technological equipment in the TR environment. Although CT scans are a usual procedure necessity in TRs, few facilities were optimized for easy access to CT-scanners for the TR. The implementation of cameras and screens was suggested as an improvement to accommodate situational awareness. Rapid sharing of data, such as imaging results, was highly sought after. Unorthodox approaches, such as the use of automatic doors, were associated with slowing down the course of actions.

This study provides health-care designers with the knowledge they need to make informed decisions when designing TRs. It will cover key considerations such as room layout, equipment selection, lighting and controls. Implementing the strategies will help minimize negative patient outcomes.

Level I TRs are a critical element of emergency departments and designing them correctly can significantly impact patient outcomes. However, designing a TR can be a complex process that requires careful consideration of various factors, including patient safety, workflow efficiency, equipment placement and infection control. This study suggests multiple considerations when designing TRs.

This study aims to explore the empirical correlation between patient flow issues, quality of green health services and patient satisfaction in specialist medical department factors from patients’ perspectives as service consumers.

This research is a type of nonintervention empirical research that uses an open survey to explore the views and experiences of users of specialist medical department services. The targeted population is hospital patients included in the top five national PERSI (Indonesian Hospital Association) Award 2022 Green Hospital Category, with a total number of respondents of 572 people. This study uses the partial least square-structural equation modeling analysis method with the SmartPLS application.

Patient flow problems generally affect the quality of eco-friendly health services, except for the waiting time problem, which affects service quality. It should be understood as a top priority for patients to receive services from medical specialists without risking time as a core service aspect from the patient’s perspective. In addition, all variables in eco-friendly hospital services affect patient satisfaction, except in the case of visits to specialist medical departments, which do not affect medical support services and hospital practices that are responsive to the delivery of care services resulting from medical support services that are inseparable in integrated services as well as health care following medical ethics.

This study has a novelty in understanding the implications of green practice in determining patient satisfaction in medical specialist department as the epicenter of hospital services and the main object of assessment for the quality of hospital services.

Value-based healthcare suggested using patient-reported information to complement the information available in the medical records and administrative healthcare data to provide insights into patients' perceptions of satisfaction, experience and self-reported outcomes. However, little attention has been devoted to questions about factors fostering the use of patient-reported information to create value at the system level.

Action research design is carried out to elicit possible triggers using the case of patient-reported experience and outcome data for breast cancer women along their clinical pathway in the clinical breast network of Tuscany (Italy).

The case shows that communication and engagement of multi-stakeholder representation are needed for making information actionable in a multi-level, multispecialty care pathway organized in a clinical network; moreover, political and managerial support from higher level governance is a stimulus for legitimizing the use for quality improvement. At the organizational level, an external facilitator disclosing and discussing real-world uses of collected data is a trigger to link measures to action. Also, clinical champion(s) and clear goals are key success factors. Nonetheless, resource munificent and dedicated information support tools together with education and learning routines are enabling factors.

Current literature focuses on key factors that impact performance information use often considering unidimensional performance and internal sources of information. The use of patient/user-reported information is not yet well-studied especially in supporting quality improvement in multi-stakeholder governance. The work appears relevant for the implications it carries, especially for policymakers and public sector managers when confronting the gap in patient-reported measures for quality improvement.

Lean Six Sigma in public and private healthcare organisations has received considerable attention over the last decade. Nevertheless, such process improvement methodologies are not generalizable, and their effective implementation relies on contextual variables. The purpose of this study is to explore the readiness of Italian hospitals for Lean Six Sigma and Quality Performance Improvement (LSS&QPI), with a focus on gender differences.

A survey comprising 441 healthcare professionals from public and private hospitals was conducted. Multivariate analysis of variance was used to determine the mean scores on the LSS&QPI dimensions based on hospital type, gender and their interaction.

The results showed that public healthcare professional are more aware of quality performance improvement initiatives than private healthcare professionals. Moreover, gender differences emerged according to the type of hospital, with higher awareness for men than women in public hospitals, whereas for private hospitals the opposite was true.

This study contributes to the Lean Six Sigma literature by focusing on the holistic assessment of LSS&QPI implementation.

This study informs healthcare managers about the revolution within healthcare organisations, especially public ones. Healthcare managers should spend time understanding Lean Six Sigma as a strategic orientation to promote the “lean hospital”, improving processes and fostering patient-centredness.

This is a preliminary study focussing on analysing inter-relationship between perceived importance of soft readiness factors such as gender dynamics as a missing jigsaw in the current literature. In addition, the research advances a holistic assessment of LSS&QPI, which sets it apart from the studies on single initiatives that have been documented to date.

The purpose of this paper is to study haemodynamic flow characteristics and entropy analysis in a bifurcated artery system subjected to stenosis, magnetohydrodynamic (MHD) flow and aneurysm conditions. The findings of this study offer significant insights into the intricate interplay encompassing electro-osmosis, MHD flow, microorganisms, Joule heating and the ternary hybrid nanofluid.

The governing equations are first non-dimensionalised, and subsequently, a coordinate transformation is used to regularise the irregular boundaries. The discretisation of the governing equations is accomplished by using the Crank–Nicolson scheme. Furthermore, the tri-diagonal matrix algorithm is applied to solve the resulting matrix arising from the discretisation.

The investigation reveals that the velocity profile experiences enhancement with an increase in the Debye–Hückel parameter, whereas the magnetic field parameter exhibits the opposite effect, reducing the velocity profile. A comparative study demonstrates the velocity distribution in Au-CuO hybrid nanofluid and Au-CuO-GO ternary hybrid nanofluid. The results indicate a notable enhancement in velocity for the ternary hybrid nanofluid compared to the hybrid nanofluids. Moreover, an increase in the Brinkmann number results in an augmentation in entropy generation.

This study investigates the flow characteristics and entropy analysis in a bifurcated artery system subjected to stenosis, MHD flow and aneurysm conditions. The governing equations are non-dimensionalised, and a coordinate transformation is applied to regularise the irregular boundaries. The Crank–Nicolson scheme is used to model blood flow in the presence of a ternary hybrid nanofluid (Au-CuO-GO/blood) within the arterial domain. The findings shed light on the complex interactions involving stenosis, MHD flow, aneurysms, Joule heating and the ternary hybrid nanofluid. The results indicate a decrease in the wall shear stress (WSS) profile with increasing stenosis size. The MHD effects are observed to influence the velocity distribution, as the velocity profile exhibits a declining nature with an increase in the Hartmann number. In addition, entropy generation increases with an enhancement in the Brinkmann number. This research contributes to understanding fluid dynamics and heat transfer mechanisms in bifurcated arteries, providing valuable insights for diagnosing and treating cardiovascular diseases.