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The COVID-19 pandemic significantly increased demand for medical and protective equipment by frontline health workers, as well as the general community, causing the supply chain to stretch beyond capacity, an issue further heightened by geographical and political lockdowns. Various 3D printing technologies were quickly utilised by businesses, institutions and individuals to manufacture a range of products on-demand, close to where they were needed. This study gathered data about 91 3D printed projects initiated prior to April 1, 2020, as the virus spread globally. It found that 60% of products were for personal protective equipment, of which 62% were 3D printed face shields. Fused filament fabrication was the most common 3D print technology used, and websites were the most popular means of centralising project information. The project data provides objective, quantitative insight balanced with qualitative critical review of the broad trends, opportunities and challenges that could be used by governments, health and medical bodies, manufacturing organisations and the 3D printing community to streamline the current response, as well as plan for future crises using a distributed, flexible manufacturing approach.

This paper explores how exaptive innovation process might be considered a useful innovation model in constraint-based environments. Through an in-depth case study, it illustrates clearly the antecedents of exaptation processes, which are particularly relevant in rapidly changing environments requiring new solutions under time and resource constraints.

The authors adopt a single case study approach that is particularly suitable in case of an inductive research design, which is required because of the novelty of the topic. The research is inspired by the use of the snorkeling mask EASYBREATH, commercialized by the giant Decathlon, as a medical device, a respirator to treat patients affected by coronavirus in Italy. The authors organized the evidence according to a novel taxonomy grounded in the literature.

The case study stimulates reflections on the existence of some antecedents to the exaptive innovation process in constraint-based environments: (1) the availability of specific actors in the innovation process; (2) the creation of platforms of interaction between people with different competences, nurtured by collective bottom-up financing systems; (3) the role of the community of makers, in particular, and of the 4th industrial revolution, in general, for creating enabling technologies; (4) multidisciplinary individual background of key actors in the innovation process is crucial to ensure the exaptive path to be in place.

This work has some limitations, due to the choice of limiting the analysis to a single case, nevertheless, it offers a first glance on a new technological trajectory available in constraint-based environments.

The case study results underline the importance of new digital collaboration platforms as knowledge multipliers, and illuminate on the potential of the fourth manufacturing revolution, which, through new technologies, creates opportunities for distributed forms of innovation that cross long distances.

Additive manufacturing (AM) technologies, also known as three-dimensional printing (3DP), is a technological breakthrough that have the potential to disrupt the traditional operations of supply chains. They open the way to a supply chains innovation that can significantly benefit hospitals and health-related organizations in dealing with crises or unexpected events in a faster and more flexible way. In this study the authors identify the boundary of this potential support.

The authors adopt a case study approach to understand the dynamics behind a well-known best practice to identify the main opportunities and the main pitfalls that AM may pose to health-related organizations wanting to leverage them.

The case highlights that it is possible to increase hospital flexibility using AM and that by leveraging the Internet it is possible to spread the benefits faster than what it would be normally possible using traditional supply chain processes. At the same time the case highlights that leveraging these technologies needs buy-in from all the relevant stakeholders.

The paper is one of the first, to the best of the authors' knowledge, to highlight the main opportunities and difficulties of implementing 3DP technologies in hospital supply chain management.