Search results

The authors determine how the scheduling and sequencing of surgeries by surgeons impacts the rate of post-surgical complications and patient length-of-stay in the hospital.

Leveraging a dataset of 29,169 surgeries performed by 111 surgeons from a large hospital network in Ontario, Canada, the authors perform a matched case-control regression analysis. The empirical findings are contextualized by interviews with surgeons from the authors’ dataset.

Surgical complications and longer hospital stays are more likely to occur in technically complex surgeries that follow a similarly complex surgery. The increased complication risk and length-of-hospital-stay is not mitigated by scheduling greater slack time between surgeries nor is it isolated to a few problematic surgery types, surgeons, surgical team configurations or temporal factors such as the timing of surgery within an operating day.

There are four major limitations: (1) the inability to access data that reveals the cognition behind the behavior of the task performer and then directly links this behavior to quality outcomes; (2) the authors’ definition of task complexity may be too simplistic; (3) the authors’ analysis is predicated on the fact that surgeons in the study are independent contractors with hospital privileges and are responsible for scheduling the patients they operate on rather than outsourcing this responsibility to a scheduler (i.e. either a software system or an administrative professional); (4) although the empirical strategy attempts to control for confounding factors and selection bias in the estimate of the treatment effects, the authors cannot rule out that an unobserved confounder may be driving the results.

The study demonstrates that the scheduling and sequencing of patients can affect service quality outcomes (i.e. post-surgical complications) and investigates the effect that two operational levers have on performance. In particular, the authors find that introducing additional slack time between surgeries does not reduce the odds of back-to-back complications. This result runs counter to the traditional operations management perspective, which suggests scheduling more slack time between tasks may prevent or mitigate issues as they arise. However, the authors do find evidence suggesting that the risk of back-to-back complications may be reduced when surgical pairings are less complex and when the method involved in performing consecutive surgeries varies. Thus, interspersing procedures of different complexity levels may help to prevent poor quality outcomes.

The authors empirically connect choices made in scheduling work that varies in task complexity and to patient-centric health outcomes. The results have implications for achieving high-quality outcomes in settings where professionals deliver a variety of technically complex services.

To explore the perceptions of surgical team members in a tertiary hospital in Jordan toward the factors influencing patient safety culture (PSC).

This was a qualitative descriptive study intended to characterize the factors that influence PSC. Interviews were conducted with health-care providers in the operation room (OR) in a tertiary Jordanian hospital. Participants included surgeons, anesthetists, nurses and senior surgical residents who had worked for three years minimum in the OR. Thematic analysis was used to analyze the data.

A total of 33 interviews were conducted. Thematic analysis of the content yielded four major themes: (1) operational factors, (2) organizational factors, (3) health-care professionals factors and (4) patient factors. The respondents emphasized the role of the physical layout of the OR, implementing new techniques and new equipment, and management support to establish a safety culture in the operating room setting.

The present research study will have implications for hospitals and health-care providers in Jordan for developing organizational strategies to eliminate or decrease the occurrence of adverse events and improve patient safety in the OR.

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.

The purpose of this paper is to explore the perceptions of operating room staff towards the use of the World Health Organization Surgical Safety Checklist in a tertiary hospital in Jordan.

This was a qualitative descriptive study. Semi-structured interviews were conducted with a purposeful sample of 21 healthcare staff employed in the operating room (nurses, residents, surgeons and anaesthesiologists). The interviews were conducted in the period from October to December 2021. Thematic analysis was used to analyse the data.

Three main themes emerged from data analysis namely compliance with the surgical safety checklist, the impact of surgical safety checklist, and barriers and facilitators to the use of the surgical safety checklist. The use of the checklist was seen as enabling staff to communicate effectively and thus to accomplish patient safety and positive outcomes. The perceived barriers to compliance included excessive workload, congestion and lack of training and awareness. Enhanced training and education were thought to improve the utilization of the surgical safety checklist, and help enhance awareness about its importance.

While steps to utilize the surgical safety checklist by the operation room personnel may seem simple, the quality of its administration is not necessarily robust. There are several challenges for consistent, complete and effective administration of the surgical safety checklist by the surgical team members. Healthcare managers must employ interventions to eliminate barriers to and offer facilitators of adherence to the application of the surgical safety checklist, therefore promoting quality healthcare and patient safety.

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.

Assess the realistic impacts of implementing an Radio Frequency Identification (RFID)/Internet of Things (IoT) uniforms’ distribution system for managing medical personnel’s scrubs in operating rooms. The authors use a hybrid simulation framework to address the following objectives and challenges: a) reduce and control operating rooms’ level of inventory; b) stabilize scrubs’ demand and c) improve infection control and prevention of cross-contamination (through scrubs over manipulation and hoarding).

The authors adopt a Design Science approach. This methodological approach is used to design, develop, create and evaluate information technology “artifacts” (e.g. constructs, models, methods and instantiations) intended to solve organizational problems and make research contributions (Peffers et al., 2007). More specifically, the authors follow the Design Science Research Methodology process model which includes six steps: problem identification and motivation, definition of the objectives for a solution, design and development, demonstration, evaluation, and communication.

To assess the realistic impacts of implementing an RFID-IoT uniforms’ distribution system for managing medical personnel’s scrubs in operating rooms, the authors adopted a design science approach and initiated the research by documenting the business case and reviewed the existing literature to build a comparative analysis of existing uniforms’ distribution systems. The authors used a hybrid simulation model to assess the impact of three business cases: present mode of operation, implementing smart shelves or the smart distributors. The authors show that smart dispensers allow a greater control on scrubs’ utilization while eliminating the cross-contamination of the medical personnel.

Through this research study, the authors provide hospitals’ managers a scientific support for uniforms’ (scrubs) distribution process improvement. The authors use a hybrid simulation model to compare innovative solutions for uniforms’ distribution systems in the form of “smart cabinets” supported by Radio Frequency Identification (RFID)/Internet of Things (IoT) technologies and choose the most appropriate design for the hospital to meet two main challenges: a) inefficiency of uniform replenishment-distribution system and b) noncompliancy with infection control regulations caused by the distribution system.

From a methodological perspective, this paper addresses concerns from researchers calling quantitative research methods and using case-based research strategy to address IoT issues and assess the system in practice. From a broader point of view, this work confirms the predominant interest of RFID-IoT research work in the arena of supply chain management and logistics as the technology is used for tracking purpose and for monitoring applications. It is also one response to the research community suggesting that “hospitals should evaluate the medical effectiveness of the new technologies as well as the cost before adoption”.

The purpose of this paper is to conceptualise our understanding of public value accounting (PVA) by studying the use and usefulness of performance measurements (PM) as a management tool. The authors do this from a perspective in which they address the complexity of various (sometimes conflicting) assessments of performance measurement and management (PMM) by different stakeholders.

An interpretative case study using qualitative methods. The paper is based on 30 interviews conducted in 2018 and 2019 with respondents working with PMM at different levels, such as politicians, officials and health-care professionals. The study context was Region Stockholm (RS) in Sweden and its health-care division.

PMs become an instrumental tool for PMM, which led to output being promoted above outcome. The authors show that there is a conceptual shortcoming in the discussion of PVA, as the effort needed to achieve outcome-based information might exceed the ability of an organisation to deliver it. The authors address the importance of studying the interaction among different stakeholders, including politicians, the public and media, in research on PVA, as well as possible power relationships among stakeholders.

The authors contribute to the growing research on PVA and its call for more empirical research by offering a more nuanced interpretation of PVA activities. The authors do this by studying PMM and the nature of these activities in a public sector organisation from a multiple-stakeholder perspective.

Digital transformation affected modern society influencing how businesses cooperate and produce value. In this context, Artificial Intelligence plays a critical role. This study aims to explore the role of Artificial Intelligence in organisational positioning within the market, influencing firms' competitiveness. In this vein, this research seeks to respond to the following research question: How does AI impact the competitive advantage of healthcare organizations?.

To tackle the research question, an explorative analysis using the case study method to investigate an international healthcare center in Dubai was conducted. Nine semi-structured interviews were conducted with the head and the members of the robotic surgery team in CMC Dubai to thoroughly understand what the components of the robotic approach are and how the arrangement before the introduction of this innovative technique while shedding light on the added value and the advantages of adopting such technique on both patient safety and patient satisfaction. Additionally, archival data and online documentation (e.g. industry reports, newspaper articles and internal documents) were analyzed to obtain data triangulation.

The results highlight three primary outcomes influenced by implementing AI in organizational processes: clinical, financial and technological outcomes. The study will offer interesting non-studied insights about the implementation of Artificial Intelligence tools in the healthcare sector and specifically robotic surgeries, and to which extent this will contribute and represent a competitive advantage. Results will hopefully insert a brick in the wall of the impact of AI tools on the quality and the results of surgical operations while emphasizing the benefits of integrating AI in surgical practice.

This study offers interesting theoretical and practical implications. It opens a new perspective to understand and manage AI tools in service. This research is not without limits providing valuable insights for future research.