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Surgical services are settings where resilient performance (RP) is necessary to cope with a wide range of variabilities. Although RP can benefit from a supportive built environment (BE), prior studies have focused on the operating room, giving scant attention to support areas. This study takes a broader perspective, aiming at developing BE design knowledge supportive of RP at the surgical service as a whole.

Seven BE design prescriptions developed in a previous work in the context of internal logistics of hospitals, and thus addressing interactions between workspaces, were used as a point of departure. The prescriptions were used as a data analysis framework in a case study of the surgical service of a medium-sized private hospital. The scope of the study included surgical and support areas, in addition to workflows involving patients and family members, staff, equipment, sterile instruments and materials, supplies, and waste. Data collection included document analysis, observations, interviews, and meetings with hospital staff.

Results identified 60 examples of using the prescriptions, 77% of which were related to areas other than the operating rooms. The developed design knowledge is framed as a set of prescriptions, examples, and their association to workflows and areas, indicating where it should be applied.

The design knowledge is new in surgical services and offers guidance to both BE and logistics designers.

The primary objective of this article is to examine current procurement, inventory control and management practices in modern healthcare, with a particular focus on the procurement and management of surgical supplies in a prominent public, highly specialized healthcare sector.

This study was conducted in three phases. In Phase 1, the study team interacted with various hospital management stakeholders, including the surgical hospital store, examined the current procurement process and identified challenges. Phase 2 focused on selecting items for a detailed study and collected the qualitative and quantitative details of the store department of the healthcare sector chosen. A detailed study analyzed revenue, output/demand, inventory levels, etc. In Phase 3, a decision-making framework is proposed, and inventory control systems are redesigned and demonstrated for the selected items.

It was observed that the demand for many surgical items had increased significantly over the years due to an increase in disposable/disposable items, while inventories fluctuated widely. Maximum inventory levels varied between 50 and 75%. Storage and availability were important issues for the hospital. It is assumed the hospital adopts the proposed inventory control system. In this case, the benefits can be a saving of 62% of the maximum inventory, 20% of the average stock in the system and optimal use of storage space, improving the performance and productivity of the hospital.

This study can help the healthcare sector administration to develop better systems for the procurement and delivery of common surgical items and efficient resource allocation. It can help provide adequate training to store staff. This study can help improve management/procurement policies, ordering and delivery systems, better service levels, and inventory control of items in the hospital business context. This study can serve as a pilot study to further investigate the overall hospital operations.

This study can help the healthcare sector administration develop better systems for procuring and delivering common surgical items and efficient resource allocation. It can help provide adequate training to store staff. This study can help improve management/procurement policies, ordering and delivery systems, better service levels and inventory control of items in the hospital business context. This study can serve as a pilot study to further investigate the overall hospital operations.

This study is an early attempt to develop a decision framework and inventory control system from the perspective of healthcare inventory management. The gaps identified in real hospital scenarios are investigated, and theoretically based-inventory management strategies are applied and proposed.

This paper aims to investigate the influence of post-curing temperature, post-curing time and gamma ray irradiation dose upon the tensile and compressive mechanical properties of the medical graded vat photopolymerization parts.

Medical graded vat photopolymerization specimens, made from photopolymer resin, were fabricated using bottom-up vat photopolymerization machine. Tensile and compressive tests were conducted to assess the mechanical properties. The specimens were categorized into uncured and post-curing groups. Temperature post-processing and/or gamma irradiation exposure were for post-curing specimens. The post-curing parameters considered included temperature levels of 50°C, 60°C and 70°C, with 1, 2, 3 and 4 h periods. For the gamma irradiation, the exposure doses were 25, 50, 75 and 100 kGy.

Post-curing improved the mechanical properties of medical graded vat photopolymerization parts for both tensile and compressive specimens. Post-curing temperature greater than 50°C or a prolonged post-curing period of more than 1 h made insignificant changes or deterioration in mechanical properties. The optimal post-curing condition was therefore a 50°C post-curing temperature with 1 h post-curing time. Exposure to gamma ray improved the compressive mechanical properties, but deteriorated tensile mechanical properties. Higher gamma irradiation doses could decrease the mechanical properties and also make the part more brittle, especially for doses more than 25 kGy.

The obtained results would be beneficial to the medical device manufacturer who fabricated the invasive temporary contact personalized surgical instruments by vat photopolymerization technique. In addition, it also raised awareness in excessive gamma sterilization in the medical graded vat photopolymerization parts.

The patient-side manipulator (PSM) achieves high torque capability by combining harmonic servo system with high reduction ratio and low torque motor. However, high reduction ratio can increase inertia and decrease compliance of the manipulator. To enhance the backdrivability of the minimally invasive surgical robot, this paper aims to propose a resistance torque compensation algorithm.

A resistance torque compensation algorithm based on dynamics and Luenberger observer is proposed. The dynamics are established, considering joint flexibility and an improved Stribeck friction model. The dynamic parameters are experimentally identified by using the least squares method. With the advantages of clear structure, simple implementation and fast solution speed, the Luenberger observer is selected to estimate the unmeasured dynamic information of PSM and realize the resistance torque compensation.

For low-speed surgical robots, the centrifugal force term in the dynamic model can be simplified to reduce computational complexity. Joint flexibility and an improved Stribeck friction model can be considered to improve the accuracy of the dynamic model. Experiment results show that parameter identification and estimated results of the Luenberger observer are accurate. The backdrivability of the PSM is enhanced in ease and smoothness.

This algorithm provides potential application prospects for surgical robots to maintain high torque while remaining compliant. Meanwhile, the enhanced backdrivability of the manipulator helps to improve the safety of the preoperative manual adjustment.

Soft robots are known for their excellent safe interaction ability and promising in surgical applications for their lower risks of damaging the surrounding organs when operating than their rigid counterparts. To explore the potential of soft robots in cardiac surgery, this paper aims to propose an adaptive iterative learning controller for tracking the irregular motion of the beating heart.

In continuous beating heart surgery, providing a relatively stable operating environment for the operator is crucial. It is highly necessary to use position-tracking technology to keep the target and the surgical manipulator as static as possible. To address the position tracking and control challenges associated with dynamic targets, with a focus on tracking the motion of the heart, control design work has been carried out. Considering the lag error introduced by the material properties of the soft surgical robotic arm and system delays, a controller design incorporating iterative learning control with parameter estimation was used for position control. The stability of the controller was analyzed and proven through the construction of a Lyapunov function, taking into account the unique characteristics of the soft robotic system.

The tracking performance of both the proportional-derivative (PD) position controller and the adaptive iterative learning controller are conducted on the simulated heart platform. The results of these two methods are compared and analyzed. The designed adaptive iterative learning control algorithm for position control at the end effector of the soft robotic system has demonstrated improved control precision and stability compared with traditional PD controllers. It exhibits effective compensation for periodic lag caused by system delays and material characteristics.

Tracking the beating heart, which undergoes quasi-periodic and complex motion with varying accelerations, poses a significant challenge even for rigid mechanical arms that can be precisely controlled and makes tracking targets located at the surface of the heart with the soft robot fraught with considerable difficulties. This paper originally proposes an adaptive interactive learning control algorithm to cope with the dynamic object tracking problem. The algorithm has theoretically proved its convergence and experimentally validated its performance at the cable-driven soft robot test bed.

This paper aims to identify the kind of internal climate leaders should offer health-care professionals to promote a patient safety culture in public hospitals managed by social health organizations in Brazil.

Two surveys were applied to health-care professionals working at three Brazilian public hospitals. The internal climate survey reached 1,013 respondents, and the patient safety culture survey reached 1,302 participants. Both factor and regression analyses were used to analyze the study model and determine how internal climate influences patient safety culture.

Results indicate that to promote a patient safety culture among health-care professionals, leaders should generate an internal climate based on trust to foster pride in working in the hospital. Possibly, the trust dimension is the most important one and must be developed to achieve job satisfaction and provide better services to patients.

All the hospitals studied were managed by the same Organização Social de Saúde. Due to the limited responses concerning the respondents’ profiles, demographic variables were not analyzed.

This research reveals that the trust and pride dimensions can most strongly influence a positive patient safety culture, helping hospital leaders face this huge managerial challenge of consistently delivering high standards of patient safety.

This research studies the promotion of a patient safety culture in public hospitals managed by social health organizations, characterized by greater flexibility and autonomy in health-care management and by a greater need for accountability.

The future increase of chronic diseases in the world requires new challenges in the health domain to improve patients' care from the point of view of the organizational processes, clinical pathways and technological solutions of digital health. For this reason, the present paper aims to focus on the study and application of well-known clinical practices and efficient organizational approaches through an innovative model (TALIsMAn) to support new care process redesign and digitalization for chronic patients.

In addition to specific clinical models employed to manage chronic conditions such as the Population Health Management and Chronic Care Model, we introduce a Business Process Management methodology implementation supported by a set of e-health technologies, in order to manage Care Pathways (CPs) digitalization and procedures improvement.

This study shows that telemedicine services with advanced devices and technologies are not enough to provide significant changes in the healthcare sector if other key aspects such as health processes, organizational systems, interactions between actors and responsibilities are not considered and improved. Therefore, new clinical models and organizational approaches are necessary together with a deep technological change, otherwise, theoretical benefits given by telemedicine services, which often employ advanced Information and Communication Technology (ICT) systems and devices, may not be translated into effective enhancements. They are obtained not only through the implementation of single telemedicine services, but integrating them in a wider digital ecosystem, where clinicians are supported in different clinical steps they have to perform.

The present work defines a novel methodological framework based on organizational, clinical and technological innovation, in order to redesign the territorial care for people with chronic diseases. This innovative ecosystem applied in the Italian research project TALIsMAn is based on the concept of a continuum of care and digitalization of CPs supported by Business Process Management System and telemedicine services. The main goal is to organize the different socio-medical activities in a unique and integrated IT system that should be sustainable, scalable and replicable.

Drawing on the dynamic capability view, this study aims to examine the relationships between big data analytics capability (BDAC) and sustainable supply chain performance (SSCP) by exploring the mediating effects of knowledge development (KD) in terms of knowledge acquisition, information distribution, shared meaning and achieved memory.

Data were collected by questionnaire survey from 300 manufacturing organizations. Structural equation modeling was used to test the research hypotheses.

It was found that all the dimensions of KD were positively related to BDAC and SSCP. Although no direct association was established between BDAC and SSCP, the empirical findings indicated that all the dimensions of KD fully mediated the relationship between BDAC and SSCP. This highlights that organizations need to harness KD because developing BDAC alone may not be sufficient.

No previous research has explored how KD dimensions such as knowledge acquisition, information distribution, shared meaning and achieved memory mediate the relationship between BDAC and SSCP. This paper addresses this gap in the literature and contributes to the existing debate to better understand the conditions in which BDAC affects SSCP. Pointers for future research are also identified.

This empirical study explores the intricate relationships between Industry 4.0 (I4), Lean practices and sustainable operational performance (SOP) within the dynamic context of the services sector. Rooted in the theoretical framework of Resource Orchestration Theory (ROT), the research investigates the nuanced interplay between these paradigms and their collective impact on firm performance.

The research methods included creation of a structural model, hypothesis formulation and advanced data analysis. Primary data were gathered through an online questionnaire distributed among service sector professionals. Analysis was completed using Partial Least Squares (PLS) Structural Equation Modeling (SEM) using the Smart-PLS software.

The results underscore the mediating role of Lean practices between I4 and SOP, emphasizing the imperative of harmonized integration to enhance overall firm performance. In alignment with ROT principles, the study illuminates the positive influence of Lean practices on sustainable operational outcomes.

The study contributes to the scholarly discourse on I4, Lean and Services, emphasizing the strategic necessity of integrating I4 capabilities with Lean practices. Practical insights guide practitioners in orchestrating a balanced adoption of I4 and Lean practices for SOP. This research offers actionable insights for industry leaders seeking to cultivate SOP within their organizational contexts.

This study contributes to the evolving understanding of the interplay between I4, Lean practices and SOP within the services sector, offering novel insights for both academia and industry practitioners.