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The interruption event will seriously affect the normal operation of urban rail transit lines,causing a large number of passengers to be stranded in the station and even making the train stranded in the interval between stations. This study aims to reduce the impact of interrupt events and improve service levels.

To address this issue, this paper considers the constraints of train operation safety, capacity and dynamic passenger flow demand. It proposes a method for adjusting small loops during interruption events and constructs a train operation adjustment model with the objective of minimizing the total passenger waiting time. This model enables the rapid development of train operation plans in interruption scenarios, coordinating train scheduling and line resources to minimize passenger travel time and mitigate the impact of interruptions. Regarding the proposed train operation adjustment model, an improved genetic algorithm (GA) is designed to solve it.

The model and algorithm are applied to a case study of interruption events on Beijing Subway Line 5. The results indicate that after solving the constructed model, the train departure intervals can be maintained between 1.5 min and 3 min. This ensures both the safety of train operations on the line and a good match with passengers’ travel demands, effectively reducing the total passenger waiting time and improving the service level of the urban rail transit system during interruptions. Compared to the GA algorithm, the algorithm proposed in this paper demonstrates faster convergence speed and better computational results.

This study explicitly outlines the adjustment method of using short-turn operation during operational interruptions, with train departure times and station stop times as decision variables. It takes into full consideration safety constraints on train operations, train capacity constraints and dynamic passenger demand. It has constructed a train schedule optimization model with the goal of minimizing the total waiting time for all passengers in the system.

This paper aims to propose a simulation-based performance evaluation model for the drone-based delivery of aid items to disaster-affected areas. The objective of the model is to perform analytical studies, evaluate the performance of drone delivery systems for humanitarian logistics and can support the decision-making on the operational design of the system – on where to locate drone take-off points and on assignment and scheduling of delivery tasks to drones.

This simulation model captures the dynamics and variabilities of the drone-based delivery system, including demand rates, location of demand points, time-dependent parameters and possible failures of drones’ operations. An optimization model integrated with the simulation system can update the optimality of drones’ schedules and delivery assignments.

An extensive set of experiments was performed to evaluate alternative strategies to demonstrate the effectiveness for the proposed optimization/simulation system. In the first set of experiments, the authors use the simulation-based evaluation tool for a case study for Central Florida. The goal of this set of experiments is to show how the proposed system can be used for decision-making and decision-support. The second set of experiments presents a series of numerical studies for a set of randomly generated instances.

The goal is to develop a simulation system that can allow one to evaluate performance of drone-based delivery systems, accounting for the uncertainties through simulations of real-life drone delivery flights. The proposed simulation model captures the variations in different system parameters, including interval of updating the system after receiving new information, demand parameters: the demand rate and their spatial distribution (i.e. their locations), service time parameters: travel times, setup and loading times, payload drop-off times and repair times and drone energy level: battery’s energy is impacted and requires battery change/recharging while flying.

The purpose of this study is to address the extended travel time caused by dwelling time at stations for passengers on traditional rail transit lines. To mitigate this issue, the authors propose the “Non-stop” design, which involves trains comprised of modular vehicles that can couple and uncouple from each other during operation, thereby eliminating dwelling time at stations..

The main contributions of this paper are threefold: first, to introduce the concept of non-stop rail transit lines, which, to the best of the authors’ knowledge, has not been researched in the literature; second, to develop a framework for the operation schedule of such a line; and third, the author evaluate the potential of its implementation in terms of total passenger travel time.

The total travel time was reduced by 6% to 32.91%. The results show that the savings were more significant for long commutes and low train occupancy rates.

The non-stop system can improve existing lines without the need for the construction of additional facilities, but it requires technological advances for rolling stock.

To eliminate dwelling time at stations, the authors present the “Non-stop” design, which is based on trains composed of locomotives that couple and uncouple from each other during operation, which to the best of the authors’ knowledge has not been researched in the literature.

This paper explores the effect of perceived service quality, trust, perceived value and perceived cost on patient satisfaction and loyalty as well as exploring the moderating role of the sociodemographic factors.

The data were gathered from 462 patients via a structured questionnaire, while structural equation modeling was utilized for the analysis.

Results indicated that trust, perceived value and patient satisfaction have important roles in shaping the patient loyalty, while patient satisfaction was found to fully mediate the patient’s perceived service quality. Loyalty relationship was also found to partially mediate the trust–loyalty relationship. Nonetheless, the patient’s satisfaction–loyalty relationship was found to be only moderated by the age factor.

Implications are provided to the Egyptian private hospitals in order for them to formulate improvement plans as well as set higher standards of conduct.

This original research is the first one, up to the researcher knowledge, that explores the drivers of patient satisfaction in the private hospitals in Egypt.

The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.

The methodology entails the integration of service design (SD) and action research (AR) methodologies, characterized by iterative phases that systematically alternate between action and reflective processes, fostering cycles of change and learning. Within this framework, stakeholders are engaged through semi-structured interviews, while the existing and envisioned processes are delineated and represented using BPMN 2.0. These methodological steps emphasize the development of an autonomous, patient-centric web application alongside the implementation of an adaptable and patient-oriented scheduling system. Also, business processes simulation is employed to measure key performance indicators of processes and test for potential improvements. This method is implemented in the context of the CP addressing transient loss of consciousness (TLOC), within a publicly funded hospital setting.

The methodology integrating SD and AR enables the detection of pivotal bottlenecks within diagnostic CPs and proposes optimal corrective measures to ensure uninterrupted patient care, all the while advancing the digitalization of diagnostic CP management. This study contributes to theoretical discussions by emphasizing the criticality of process optimization, the transformative potential of digitalization in healthcare and the paramount importance of user-centric design principles, and offers valuable insights into healthcare management implications.

The study’s relevance lies in its ability to enhance healthcare practices without necessitating disruptive and resource-intensive process overhauls. This pragmatic approach aligns with the imperative for healthcare organizations to improve their operations efficiently and cost-effectively, making the study’s findings relevant.

This study explores how Lean was deployed in several hospitals in the Apulia region in Italy over 3.5 years.

An exploratory qualitative design was drawn up based on semi-structured interviews.

The drivers of Lean in hospitals were to increase patient satisfaction and improve workplace well-being by eliminating non-value-add waste. The participants highlighted three key elements of the pivotal implementation stages of Lean: introduction, spontaneous and informal dissemination and strategic level implementation and highlighted critical success and failure factors that emerged for each of these stages. During the introduction, training and coaching from an external consultant were among the most impactful factors in the success of pilot projects, while time constraints and the adoption of process analysis tools were the main barriers to implementation. The experiences of the Lean teams strongly influence the process of spontaneous dissemination aided by the celebration of project results and the commitment of the departmental hospital heads.

Lean culture can spread to allow many projects be conducted spontaneously, but the Lean paradigm can struggle to be adopted strategically. Lean in healthcare can fail because of the lack of alignment of Lean with leadership in healthcare and with their strategic vision, a lack of employees' project management skills and crucially the absence of a Lean steering committee.

The absence of managerial expertise and a will to support Lean implementation do not allow for systemic adoption of Lean. This is one of the first and largest long-term case studies on a Lean cross-regional multi-hospital application in healthcare.

In an increasingly interconnected world, transportation infrastructure has emerged as a critical determinant of economic growth and global competitiveness. High-speed rail (HSR), characterized by its exceptional speed and efficiency, has garnered widespread attention as a transformative mode of transportation that transcends borders and fosters economic development. The Kuala Lumpur – Singapore (KL-SG) HSR project stands as a prominent exemplar of this paradigm, symbolizing the potential of HSR to serve as a catalyst for national economic advancement.

This paper is prepared to provide an insight into the benefits and advantages of HSR based on proven case studies and references from global HSRs, including China, Spain, France and Japan.

The findings that have been obtained focus on enhanced connectivity and accessibility, attracting foreign direct investment, revitalizing regional economies, urban development and city regeneration, boosting tourism and cultural exchange, human capital development, regional integration and environmental and sustainability benefits.

The KL-SG HSR, linking Kuala Lumpur and Singapore, epitomizes the potential for HSR to be a transformative agent in the realm of economic development. This project encapsulates the aspirations of two dynamic Southeast Asian economies, united in their pursuit of sustainable growth, enhanced connectivity and global competitiveness. By scrutinizing the KL-SG High-Speed Rail through the lens of economic benchmarking, a deeper understanding emerges of how such projects can drive progress in areas such as cross-border trade, tourism, urban development and technological innovation.

Cardiovascular diseases are the leading cause of death worldwide. In Italy, acute myocardial infarction (AMI) is a major cause of hospitalization and healthcare costs. AMI is a myocardial necrosis event caused by an unstable ischemic syndrome. The Italian government has defined an indicator called “AMI: 30-day mortality” to assess the quality of the overall care pathway of the heart attacked patient. In order to guarantee high standards, all hospitals had to implement techniques to increase the quality of care pathway. The aim of the paper is to identify the root cause and understand the mortality rate for AMI and redesign the patient management process in order to improve it.

A Lean Six Sigma (LSS) approach was used in this study to analyze the patient flow in order to reduce 30-days mortality rate from AMI registered by Complex Operative Unit (COU) of Cardiology of an Italian hospital. Value stream mapping (VSM) and Ishikawa diagrams were implemented as tools of analysis.

Process improvement using LSS methodology made it possible to reduce the overall times from 115 minutes to 75 minutes, with a reduction of 35%. In addition, the corrective actions such as the activation of a post-discharge outpatient clinic and telephone contacts allowed the 30-day mortality rate to be lowered from 16% before the project to 8% after the project. In this way, the limit value set by the Italian government was reached.

The limitation of the study is that it is single-centered and was applied to a facility with a limited number of cases.

The LSS approach has brought significant benefits to the process of managing patients with AMI. Corrective actions such as the activation of an effective shared protocol or telephone interview with checklist can become the gold standard in reducing mortality. The limitation of the study is that it is single-centered and was applied to a facility with a limited number of cases.

LSS, applied for the first time to the management of cardiovascular diseases in Italy, is a methodology which has proved to be strategic for the improvement of healthcare process. The simple solutions implemented could serve as a guide for other hospitals to pursue the national AMI mortality target.

Policies on integrated care have waxed and waned over time in the English health and care sectors, culminating in the creation of 42 integrated care systems (ICSs) which were confirmed in law in July 2022. One of the four fundamental purposes of ICSs is to tackle health inequalities. This paper reports on the content of the overarching ICS plans in order to explore how they focus on health inequalities and the strategies they intend to employ to make progress. It explores how the integrated approach of ICSs may help to facilitate progress on equity.

The analysis is based on a sample of 23 ICS strategic plans using a framework to extract relevant information on health inequalities.

The place-based nature of ICSs and the focus on working across traditional health and care boundaries with non-health partners gives the potential for them to tackle not only the inequalities in access to healthcare services, but also to address health behaviours and the wider social determinants of health inequalities. The plans reveal a commitment to addressing all three of these issues, although there is variation in their approach to tackling the wider social determinants of health and inequalities.

This study adds to our knowledge of the strategic importance assigned by the new ICSs to tackling health inequalities and illustrates the ways in which features of integrated care can facilitate progress in an area of prime importance to society.

Efficient delivery of integrated healthcare requires solid alliances and collaboration with stakeholders on a regular basis. Due to coronavirus disease 2019 (COVID-19), it has become necessary to explore new ways of delivering integrated healthcare, and virtual clinics have offered one solution and are likely to continue due to the uncertainty with COVID-19. This study aims to explore clinicians’ experiences of how efficient virtual elective knee clinics (VEKC) are in an orthopaedic setting in comparison to traditional face-to-face clinics.

The study utilised a mixed-methods study to obtain qualitative and quantitative data. This involved an anonymous online survey in addition to in-depth qualitative interviews conducted with a purposive sample of multidisciplinary colleagues who work with the VEKC in an acute hospital.

Three overarching themes and nine sub-themes emerged in the qualitative analysis. Overall, clinicians in both the quantitative and qualitative aspects of the study highlighted several ways that virtual clinics are efficient from both the patient and health service perspective. However, participants also highlighted barriers in relation to virtual clinics not being suitable for certain cohorts of patients and pathologies.

This is the first study in Ireland to provide valuable insights into the experiences of multidisciplinary clinicians using VEKC and their efficiency compared to traditional face-to-face clinics.