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Heating, ventilating, air-conditioning and cooling (HVAC) systems are crucial in daily health-care facility services. Design-related defects can lead to maintenance issues, causing service disruptions and cost overruns. These defects can be avoided if a link between the early design stages and maintenance feedback is established. This study aims to use experts’ experience in HVAC maintenance in health-care facilities to list and evaluate the risk of each maintenance issue caused by a design defect, supported by the literature.

Following semistructured interviews with experts, 41 maintenance issues were identified as the most encountered issues. Subsequently, a survey was conducted in which 44 participants evaluated the probability and impact of each design-caused issue.

Chillers were identified as the HVAC components most prone to design defects and cost impact. However, air distribution ducts and air handling units are the most critical HVAC components for maintaining healthy conditions inside health-care facilities.

The unavailability of comprehensive data on the cost impacts of all design-related defects from multiple health-care facilities limits the ability of HVAC designers to furnish case studies and quantitative approaches.

This study helps HVAC designers acquire prior knowledge of decisions that may have led to unnecessary and avoidable maintenance. These design-related maintenance issues may cause unfavorable health and cost consequences.

The integration of industry 4.0 has become a priority for many organizations. However, not all organizations are suitable and capable of implementing industry 4.0 because it requires a dynamic and flexible implementation strategy. The implementation of industry 4.0 often involves overcoming several tensions between internal and external stakeholders. This paper aims to explore the paradoxical tensions that arise for health-care organizations when integrating industry 4.0. Moreover, it discusses how a paradox lens can support the conceptualization and proposes techniques for handling tensions during the integration of industry 4.0.

This qualitative and in-depth study draws upon 32 semi-structured interviews. The empirical case concerns how two health-care organizations handle paradoxical tensions during the integration of industry 4.0.

The exploration resulted in six recurring technology tensions: technology invention (modularized design vs. flexible design), technology collaboration (automation vs. human augmentation), technology-driven patient experience (control vs. autonomy), technology uncertainty (short-term experimentation vs. long-term planning), technology invention and diffusion through collaborative efforts among stakeholders (selective vs. intensive collaboration) and technological innovation (market maintenance vs. disruption).

A paradox theory-informed conceptual model is proposed for how to handle tensions during the integration of industry 4.0. To the best of the authors’ knowledge, this is the first paper to introduce paradox theory for quality management, including lean and Six Sigma.

The study aims to explore how segmentation as a methodology can be adapted to the healthcare context to provide a more nuanced understanding of the served population and to facilitate the design of patient-centric services.

The study was based on a collaborative project with a national healthcare organization following the principles of action design research. The study describes the quantitative segmentation performed during the project, followed by a qualitative interview study of how segments correspond with patient behaviors in an actual healthcare setting, and service design workshops facilitated by segments. A number of design principles are outlined based on the learnings of the project.

The segmentation approach increased understanding of patient variability within the service provider organization and was considered an effective foundation for modular service design. Patient characteristics and life circumstances were related to specific patterns of health behaviors, such as avoidance or passivity, or a persistent proactivity. These patterns influenced the patients' preferred value co-creation role and what type of support patients sought from the care provider.

The proposed segmentation approach is immediately generalizable to further healthcare contexts and similar services: improved understanding of patients, vulnerable patients in particular, improves the fit and inclusivity of services.

The segmentation approach to service design was demonstrated to be effective in a large-scale context. The approach allows service providers to design service options that improve the fit with individual patients' needs for support and autonomy. The results illuminate how patient characteristics influence health and value co-creation behaviors.

This article analyses a major healthcare and social welfare reform establishing new regional and integrated wellbeing services counties in Finland. The authors approach the reform and service integration as a knowledge management (KM) issue and analyse how KM appears and contributes in the context of integrated care, specifically in the process of integrating social and health care.

The article analyses the case organisation's KM initiatives in light of the integrated care literature and recognises the tasks and requirements for effective KM when building integrated health and social care system. The empirical research material for this qualitative study consisted of the case organisation's strategy documents, the results of an external maturity assessment, KM workshop materials and publicly available documentation of the Finnish health and social care reform.

This study identifies the mechanisms by which KM can support health and social services integration. At the macro level, national coordination and regional co-operation require common information structures. At the meso level, a shared regional strategy with shared objectives guides both organisational decision-making and collaboration between professionals. At the micro level, technology supported and data-driven planning of service chains complements the experiences of professionals and may help remove obstacles to integration.

This study contributes to the literature on integrated care by providing a more comprehensive view of the role and tasks of knowledge and KM when reforming health and social services than approaches focussing solely on health informatics and internal efficiency.

Recent literature within public service logic has called for more explicit conceptualisation of customer value in public services. This study aims to fill this gap by examining how the customer value approach can be applied in the management of public health care services.

This study is a qualitative case study of management of public health care services in Finland. The authors interviewed 17 regional health care service developers and analyzed the interview data using thematic analysis.

The study suggests five propositions for applying customer value approach from the marketing literature in public health care service management. The study enables a deeper understanding of customer value creation in this context and improvement of public health care services.

This study contributes to the public management research in general and public service logic research in particular by suggesting what constitutes customer value in public health care services.

This study aims to provide a picture of the current state of art in the use of big data for decision-making processes for the management of health-care organizations.

A systematic literature review was carried out. The research uses two analyses: descriptive analysis, describing the evolution of citations; keywords; and the ten most influential papers, and bibliometric analysis, for content evaluation, for which a cluster analysis was performed.

A total of 48 articles were selected for bibliographic coupling out of an initial sample of more than 5,000 papers. Of the 48 articles, 29 are linked on the basis of their bibliography. Clustering the 29 articles on the basis of actual content, four research areas emerged: quality of care, quality of service, crisis management and data management.

Health-care organizations believe strongly that big data can become the most effective tool for correctly influencing the decision-making processes. Thus, more and more organizations continue to invest in big data analytics, and the literature on this topic has expanded rapidly. This study seeks to provide a comprehensive picture of the different streams of literature existing, together with gaps in research and future perspectives. The literature is mature enough for an analysis to be made and provide managers with useful insights on opportunities, criticisms and perspectives on the use of big data for health-care organizations. However, to date, there is no comprehensive literature review on the big data analysis in health care. Furthermore, as big data is a “sexy catchphrase,” more clarity on its usage may be needed. It represents an important tool to be investigated and its great potential is often yet to be discovered. This study thus sheds light on emerging issues and suggests further research that may be needed.

Introducing technology at work presents a special challenge as learning is tightly integrated with workplace practices. Current design-based research (DBR) methods are focused on formal learning context and often questioned for a lack of yielding traceable research insights. This paper aims to propose a method that extends DBR by understanding tools as sociocultural artefacts, co-designing affordances and systematically studying their adoption in practice.

The iterative practice-centred method allows the co-design of cognitive tools in DBR, makes assumptions and design decisions traceable and builds convergent evidence by consistently analysing how affordances are appropriated. This is demonstrated in the context of health-care professionals’ informal learning, and how they make sense of their experiences. The authors report an 18-month DBR case study of using various prototypes and testing the designs with practitioners through various data collection means.

By considering the cognitive level in the analysis of appropriation, the authors came to an understanding of how professionals cope with pressure in the health-care domain (domain insight); a prototype with concrete design decisions (design insight); and an understanding of how memory and sensemaking processes interact when cognitive tools are used to elaborate representations of informal learning needs (theory insight).

The method is validated in one long-term and in-depth case study. While this was necessary to gain an understanding of stakeholder concerns, build trust and apply methods over several iterations, it also potentially limits this.

Besides generating traceable research insights, the proposed DBR method allows to design technology-enhanced learning support for working domains and practices. The method is applicable in other domains and in formal learning.

The aim of this study is to explore and discuss key challenges associated with having stakeholders take part in co-designing a health care intervention to increase mobility in older medical patients admitted to two medical departments at two hospitals in Denmark.

The study used a qualitative design to investigate the challenges of co-designing an intervention in five workshops involving health professionals, patients and relatives. “Challenges” are understood as “situations of being faced with something that needs great mental or physical effort in order to be done successfully and therefore tests a person's ability” (Cambridge Dictionary). Thematic content analysis was conducted with a background in the analytical question: “What key challenges arise in the material in relation to the co-design process?”.

Two key challenges were identified: engagement and facilitation. These consisted of five sub-themes: recruiting patients and relatives, involving physicians, adjusting to a new researcher role, utilizing contextual knowledge and handling ethical dilemmas.

The population of patients and relatives participating in the workshops was small, which likely affected the co-design process.

Researchers who want to use co-design must be prepared for the extra time required and the need for skills concerning engagement, communication, facilitation, negotiation and resolution of conflict. Time is also required for ethical discussions and considerations concerning different types of knowledge creation.

Engaging stakeholders in co-design processes is increasingly encouraged. This study documents the key challenges in such processes and reports practical implications.

The aim of this paper is to identify some of the challenges that need to be addressed to accelerate the deployment and adoption of smart health technologies for ubiquitous healthcare access. The paper also explores how internet of things (IoT) and big data technologies can be combined with smart health to provide better healthcare solutions.

The authors reviewed the literature to identify the challenges which have slowed down the deployment and adoption of smart health.

The authors discussed how IoT and big data technologies can be integrated with smart health to address some of the challenges to improve health-care availability, access and costs.

The results of this paper will help health-care designers, professionals and researchers design better health-care information systems.

This study aims to deepen the understanding of the challenges and implications entailed by deploying mobile clinics in conflict zones to reach populations affected by violence and cut off from health-care services.

This research combines an integrated literature review and an instrumental case study. The literature review comprises two targeted reviews to provide insights: one on conflict zones and one on mobile clinics. The case study describes the process and challenges faced throughout a mobile clinic deployment during and after the Iraq War. The data was gathered using mixed methods over a two-year period (2017–2018).

Armed conflicts directly impact the populations’ health and access to health care. Mobile clinic deployments are often used and recommended to provide health-care access to vulnerable populations cut off from health-care services. However, there is a dearth of peer-reviewed literature documenting decision support tools for mobile clinic deployments.

This study highlights the gaps in the literature and provides direction for future research to support the development of valuable insights and decision support tools for practitioners.