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This work aims to integrate the concepts generated by a systematic literature review on patient flows in emergency departments (ED) to serve as a basis for developing a generic process model for ED.

A systematic literature review was conducted using PRISMA guidelines, considering Lean Healthcare interventions describing ED patients’ flows. The initial search found 141 articles and 18 were included in the systematic analysis. The literature analysis served as the basis for developing a generic process model for ED.

ED processes have been represented using different notations, such as value stream mapping and workflows. The main alternatives for starting events are arrival by ambulance or walk-in. The Manchester Triage Scale (MTS) was the most common protocol referred to in the literature. The most common end events are admission to a hospital, transfer to other facilities or admission to an ambulatory care system. The literature analysis allowed the development of a generic process model for emergency departments. Nevertheless, considering that several factors influence the process of an emergency department, such as pathologies, infrastructure, available teams and local regulations, modelling alternatives and challenges in each step of the process should be analysed according to the local context.

A generic business process model was developed using BPMN that can be used by practitioners and researchers to reduce the effort in the initial stages of design or improvement projects. Moreover, it’s a first step toward the development of generalizable and replicable solutions for emergency departments.

Patient length of stay (LOS) is an important indicator of emergency department (ED) performance. Investigating factors that influence LOS could thus improve healthcare delivery and patient safety. Previous studies have focused on patient-level factors to explain LOS variation, with little research into service-related factors. This study examined the association between LOS and multi-level factors including patient-, service- and organization-level factors.

This study uses a retrospective observational design to identify a cohort of patients from arrival to discharge from ED. A year-long data regarding patients flow trhoguh ED were analyzed using analytics techniques and multi-regression models. The response variable was patient LOS, and the independent variables were patient characteristics, service-related factors and organizational variables.

The findings of this study showed that older patients, middle triage and hospitalization were all associated with longer LOS. Service-related factors such as complexity of care provided, initial ward designation and ward transfer had a significant impact as well. Finally, prolonged LOS was associated with a higher ratio of patients per medical doctor and per nurse. In contrast, a higher number of residents in the ED were associated with longer patient LOS.

Previous studies on patient LOS have focused on patient-level factors, with little research on service-related factors. This study has addressed that gap by examining the association between LOS and multi-level factors including patient-, service- and organization-level factors. Patient-level factors included demographics, acuity, arrival shift, arrival mode and discharge type. Service-level factors consisted of first ward, ward transfer and complexity of care provided. Organizational factors consisted of three ratios: patients per MD, patients per nurse and patients per resident. The results add to the current understanding of factors that increase patient LOS in EDs and contribute to the body of knowledge on ED performance, operation management and quality of care. The study also provides practical and managerial insights that could be used to improve patient flow in EDs and reduce LOS.

This paper conceptualises how managers psychologically experience and respond to crises via metaphor analysis.

This paper uses a discourse dynamics approach to metaphor analysis. Conceptual metaphors were analysed and developed into concept maps through 37 semi-structured interviews with senior managers from different portfolios within 16 public universities in South Africa after #FeesMustFall protests.

Five domains emerged, including (1) looming crisis, (2) crisis onset, (3) crisis triage and containment, (4) (not) taking action and (5) post-crisis reflection. These domains shape a framework for the crisis adaptation cycle.

This study suggests that organisations should pay more attention to understanding emotions in crises and can use the adaptation model to develop their managers. It shows how metaphors can help explain affective and cognitive experiences and how emotions shift and evolve during a crisis. Managers should be aware of early signs of the crisis and its potential impact on their business operation in the looming and recognition stages, analyse the situation and work collectively on possible actions to minimise losses and maximise gains.

This is a rare investigation into the emotions of senior managers in the public sector in a social movement and national crisis via unconventional research methods to advance cognitive appraisal theory in crisis management.

Major incidents in road tunnels remain a collaborative challenge for the emergency services (fire and rescue service, police and ambulance), emergency dispatch centres (EDCs) and infrastructure owners. The aim of this paper is to investigate how collaborative partners to the ambulance services perceive the rescue effort and to identify factors that may influence its efficiency.

Focus group and individual interviews were conducted with 19 participants who were infrastructure owners or had operational or tactical responsibilities with the emergency services or EDCs in two regions in Sweden with multiple road tunnels. The collected data were analysed using qualitative content analysis.

Three main categories described efficiency factors during and after an incident: (1) coordinating the initial information (using a shared terminology), (2) achieving situational awareness (identifying those persons in need) and (3) lessons (not) learnt (lack of joint tactical plans and exercises). The emerging theme was access, assess and evaluate.

The findings suggest that establishing national policies and collaborative forums might yield more efficiently managed rescue efforts in road tunnel incidents in Sweden and other countries with similar organisational structures.

This study offers new insights on interoperability during responses to complex underground incidents.

Recent years have witnessed an unexpected and astonishing rise of AI-generated (AIGC), thanks to the rapid advancement of technology and the omnipresence of social media. AIGCs created to mislead are more commonly known as DeepFakes, which erode our trust in online information and have already caused real damage. Thus, countermeasures must be developed to limit the negative impacts of AIGC. This position paper aims to provide a conceptual analysis of the impact of DeepFakes considering the production cost and overview counter technologies to fight DeepFakes. We will also discuss future perspectives of AIGC and their counter technology.

We summarize recent developments in generative AI and AIGC, as well as technical developments to mitigate the harmful impacts of DeepFakes. We also provide an analysis of the cost-effect tradeoff of DeepFakes.

The mitigation of DeepFakes call for multi-disciplinary research across the traditional disciplinary boundaries.

Government and business sectors need to work together to provide sustainable solutions to the DeepFake problem.

The research and development in counter-technologies and other mitigation measures of DeepFakes are important components for the health of future information ecosystem and democracy.

Unlike existing reviews in this topic, our position paper focuses on the insights and perspective of this vexing sociotechnical problem of our time, providing a more global picture of the solutions landscape.

Disaster management and humanitarian logistics (HT) play crucial roles in large-scale events such as earthquakes, floods, hurricanes and tsunamis. Well-organized disaster response is crucial for effectively managing medical centres, staff allocation and casualty distribution during emergencies. To address this issue, this study aims to introduce a multi-objective stochastic programming model to enhance disaster preparedness and response, focusing on the critical first 72 h after earthquakes. The purpose is to optimize the allocation of resources, temporary medical centres and medical staff to save lives effectively.

This study uses stochastic programming-based dynamic modelling and a discrete-time Markov Chain to address uncertainty. The model considers potential road and hospital damage and distance limits and introduces an a-reliability level for untreated casualties. It divides the initial 72 h into four periods to capture earthquake dynamics.

Using a real case study in Istanbul’s Kartal district, the model’s effectiveness is demonstrated for earthquake scenarios. Key insights include optimal medical centre locations, required capacities, necessary medical staff and casualty allocation strategies, all vital for efficient disaster response within the critical first 72 h.

This study innovates by integrating stochastic programming and dynamic modelling to tackle post-disaster medical response. The use of a Markov Chain for uncertain health conditions and focus on the immediate aftermath of earthquakes offer practical value. By optimizing resource allocation amid uncertainties, the study contributes significantly to disaster management and HT research.