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The purpose of this paper is to design and manufacture an intelligent 3D printed sensor to monitor the re-occurrence of diaphragmatic hernia (DH; after surgery) in bovines as an Internet of Things (IOT)-based solution.

The approach used in this study is based on a bibliographic analysis for the re-occurrence of DH in the bovine after surgery. Using SolidWorks and ANSYS, the computer-aided design model of the implant was 3D printed based on literature and discussions on surgical techniques with a veterinarian. To ensure the error-proof design, load test and strain–stress rate analyses with boundary distortion have been carried out for the implant sub-assembly.

An innovative IOT-based additive manufacturing solution has been presented for the construction of a mesh-type sensor (for the health monitoring of bovine after surgery).

An innovative mesh-type sensor has been fabricated by integration of metal and polymer 3D printing (comprising 17–4 precipitate hardened stainless steel and polyvinylidene fluoride-hydroxyapatite-chitosan) without sacrificing strength and specific absorption ratio value.

While attempting to persuade surgeons to accept their health technology, sales representatives for medical devices face daily challenges in the operating room. Surgeons exhibit cognitive complexity (abstractness vs. concreteness) when accepting any form of health technology. Surgeons choose technologies on behalf of their patients, taking patient priorities and expectations into account. Prior research has focused on cognitive complexity in the context of health technology adoption, but the issue of technology acceptance has not been addressed. The purpose of this study to use the construal level (CL) theory to determine the role of behavioural abstraction levels in the acceptance of surgical health technology.

On the basis of 556 min of seminar-based data and semi-directive interviews, the surgeons’ experiences regarding the acceptance of health technology were analysed. A non-directive observational method was used to permit the spontaneous emergence of CL dimensions in a natural environment. A categorization model was used for data coding, and MAXQDA, in addition to traditional multidimensional scaling and hierarchical cluster analysis, was used to generate results with joint displays.

Effort expectancy, learning curve, performance risk, habit, patient clinical condition, clinical outcome expectancy, technology setting and social influence were construed at a low construal level (LCL). On the other hand, patient paying capacity, technology cost, price value, financial risk and patient performance expectation were construed at a high construal level (HCL). The study also reveals duality-based factors which showed proximity to HCL but intersected at LCL, and vice versa. Duality-based factors such as effort expectancy, surgical technique, trust and perceived risk intersected at HCL, whereas performance expectancy, relative advantage, time expectancy, perceived value, physical risk and peer group influence intersected at LCL.

This is one of the early studies that presented the impact of behavioural abstraction on behavioural intention to accept health technology for surgeries.

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.

The purpose of the study is to measure the performance of Indian hospitals, both operationally and financially, by using hospital KPI's. The assessment is predominantly done by linking it to the existing Lean practices in Indian hospitals.

An empirical study based on cross-sectional survey of hospital managers and specialists in various private healthcare facilities across India was conducted to validate the proposed Lean framework. From an extensive literature survey, the authors identified quality, delivery, efficiency, accessibility and patient centeredness to be the main operational performance (OP) indicators for hospitals. Business or financial performance was measured based on parameters which are average revenue per occupied bed (ARPOB), earnings before interest, tax, depreciation and amortization (EBITDA) and operating revenue. Confirmatory Factor Analysis (CFA) was carried out using a specialized technique, called Structural Equation Modelling(SEM) and an explicit factor structure was hypothesized.

Management commitment towards Lean in hospitals is statistically proven to have impacted operational and financial performance. However, leanness in technology and business processes showed no statistical significance on either operational or financial performance parameters. Hospital stakeholders showed statistical significance on though it had no impact on the financial performance. Results obtained from the statistical analysis indicate a positive impact of hospital Lean practices on timely delivery of services and improved service quality. Efficiency, accessibility of services and patient centered behavior in hospital operations could not be statistically proven to have impacted the financial performance.

Effectiveness of Lean management (LM) principles in improving hospital operations is largely dependent on patient centered behavior. Empowered employees who are trained to add value from a customer view point, make hospital operations safe and improved. Properly trained and communicated employees who are committed to quality improvements can make a positive impact on patients' quality of life and thus positively impact the society. The study lists ways to attain the required outcomes.

This paper is among the very few that has attempted to suggest ways to link implementation of Lean practices more effectively in Indian hospitals to improve hospital performance at operational and financial levels.

Idea of circular economy defies the classical “make-use-dispose” approach of linear economic model. In the context of health-care industry, it relies heavily on the supply chain practices implemented by industry stakeholders. The purpose of this study is to explore such relationships, study their structure and put it across for attaining sustainability at large.

This study is an empirical research conducted on 145 health-care firms. The collected data is analysed to develop structural and measurement model. The five constructed hypotheses are examined and tested through structural equation modelling.

The study illustrates the latent relationships that exist among the stakeholders involvement, sustainable supply chain practices, sustainable performance and circular economy for health-care industry. It is found that the adoption of sustainable supply chain practices improves health-care performance, which, in turn, have positive influence on circular economy.

The structural and measurement model is developed in the context of circular health-care economy. It can be validated or improvised by conducting similar research in other industry using different methods. This research work fulfils the long existing gap in research by offering a linkage between various constructs to achieve health-care circular economy. Based on the research results, future researchers can build theories of circular economy and sustainability for health-care industry.

The study attempts to study the supply chain ways to achieve circular economy for Indian health-care sector. It considered latent relationships among the set of constructs, which are needed for theory building at later stage.

This paper aims to characterize a sample of Lean Six Sigma (LSS) projects in healthcare settings and discuss some specificities of operational excellence (OPEX) initiatives in hospitals and healthcare organizations in the USA.

A content analysis involving a sample of 23 documents shared by US hospitals was performed in order to achieve the research objectives. Such analysis was based on a conceptual framework developed from the literature review. It was also applied to a quantitative approach, including descriptive statistics, hypothesis testing and correspondence analysis that supported the research.

Most LSSH projects were focused on business transformation and strategic improvements. Simple techniques and tools were predominant such as descriptive statistics, process mapping, 5S and spaghetti charts, usually implemented by Green Belts and Black Belts through the define, measure, analyze, improve and control (DMAIC) method. In addition to the expressive findings reported, these projects' results have been aligned with lead time and operational cost reduction, quality improvement and capacity increase.

The study adds knowledge to the OPEX literature by analyzing the Lean Six Sigma healthcare (LSSH) in hospitals and healthcare institutions in the USA. It also demonstrates that different approaches, such as the kaizen event and DMAIC project show different results according to some techniques and tools applied in the hospital environment.

The empirical evidence presented in this study provides scenery of the LSS practices in the healthcare settings, highlighting the implementation areas, outcomes, tools and techniques mostly used in the North American healthcare institutions.

Ti6Al4V alloy patient-customized implants (PCI) are often fabricated using laser powder bed fusion (LPBF) and annealed to enhance the microstructural, physical and mechanical properties. This study aims to demonstrate the effects of annealing on the physio-mechanical properties to select optimal process parameters.

Test samples were fabricated using the Taguchi L9 approach by varying parameters such as laser power (LP), laser velocity (LV) and hatch distance (HD) to three levels. Physical and mechanical test results were used to optimize the parameters for fabricating as-built and annealed implants separately using Grey relational analysis. An optimized parameter set was used for fabricating biological test samples, followed by animal testing to validate the qualified parameters.

Two optimized sets of process parameters (LP = 100 W, LV = 500 mm/s and HD = 0.08 mm; and LP = 300 W, LV = 1,350 mm/s and HD = 0.08 mm) are suggested suitable for implant fabrication regardless of the inclusion of annealing in the manufacturing process. The absence of any necrosis or reaction on the local tissues after nine weeks validated the suitability of the parameter set for implants.

To help PCI manufacturers in parameter selection and to exclude annealing from the manufacturing process for faster implant delivery.

To the best of the authors’ knowledge, this is probably a first attempt that suggests LPBF parameters that are independent of inclusion of annealing in implant fabrication process.

The Indian pharmaceutical industry has contributed significantly to global healthcare by securing superior-quality, inexpensive and reachable medicines worldwide. However, supply chain management (SCM) has been challenging due to constantly shifting requirements for short lifecycles of products, the convergence of industry and changeable realities on the ground. This study aims to identify, assess and prioritize the strengths, weaknesses and opportunities of the pharmaceutical SCM environment in India.

The paper employs a Strength, Weakness, Opportunity, Threat (SWOT) analysis and recognizes strategies to utilize the advantages of the strengths and opportunities, rectify weaknesses and resolve threats.

A variety of strategies that could have a positive effect on the Indian pharmaceutical business are presented. Findings and suggested strategies can significantly advance knowledge, enhance understanding and contribute to the growth of a successful SCM for the Indian pharmaceutical sector.

This paper would act as a roadmap to greater comprehension of the market leaders and market leaders' operating climate. The findings from this study will offer academic scholars and business practitioners deeper insights into the environment of SCM.

Family business sustainability is a critical issue. This study considers if adopting a strategic entrepreneurship orientation can support the sustainability of a family business.

A qualitative approach is used, in which semi-structured interviews were conducted with twelve family business owners. Data collected during the interviews provides insights into understanding, practices, motivations, behaviours and attitudes relating to sustainability.

Although awareness of sustainability processes and procedures is found to be low, sustainability is important to the family business. However, sustainability is not managed or implemented systematically.

The paper presents a new model to describe the sustainability practices of family businesses. Adoption of strategic entrepreneurship is advocated as mechanism for improving sustainability. Practical and policy implications are suggested to enhance the effectiveness of sustainability initiatives in family business settings.