Design and process optimization of combined medical and elderly care services: An integrated service blueprint-TRIZ model.

China's increasingly aging population is resulting in an imbalance between supply and demand for elderly care resources. The theory of "combined medical and elderly care" (CMEC) has introduced a new perspective in the conception of China's elderly care problems. This study employed the service blueprint, fuzzy failure mode and effects analysis (Fuzzy-FMEA), and the theory of inventive problem solving (TIPS or the Russian acronym TRIZ) for the process optimization of CMEC services in three phases. In the first phase (service process analysis), potential service failure points in the service process were analyzed using the service blueprint technique. In the second phase (service failure diagnosis), Fuzzy-FMEA was applied to diagnose the service failure modes and explore the possible causes and effects. The service failure modes were then prioritized based on fuzzy numbers and the cumulative fuzzy risk priority number (Fuzzy-RPN). Finally, in the third phase (generation of service optimization solutions), the TRIZ parameters, inventive principles, and contradiction matrix were first employed to select TRIZ inventive principles. The selected TRIZ inventive principles were then used to inspire inventive solutions for new service processes. Finally, a case study was conducted on the service processes of elderly care institutions to demonstrate the applicability of the optimization solutions.

Diamond Model of Green Commitment and Low-Carbon Travel Motivation, Constraint, and Intention.

Although consumers generally accept and care about environmental issues, consumers have not adjusted their behavior accordingly. Based on the diamond model theory, this study proposes and tests the direct impact of personal green commitments on low-carbon travel motivation and constraint, and the possibility of subsequent low-carbon travel intention. According to the results of 358 valid questionnaire surveys, this study shows that green commitments positively affect the low-carbon travel motivation and intention, while negatively affecting the low-carbon travel constraint. The low-carbon travel motivation has some mediating effects. The research results can be used as a reference by relevant managers of the tourism industry to make changes in the content of travel services that are more suitable for specific populations.

Exploring the Relationship Between Hospital Service Quality, Patient Trust, and Loyalty From a Service Encounter Perspective in Elderly With Chronic Diseases.

Based on the service encounter perspective, this study combines theoretical foundations for such factors as service quality and the characteristics of the hospital service industry to develop a research model scale to investigate whether the quality of hospital services affects patients' perceptions of health service encounters, trust, and loyalty. Nowadays, with the advancement of medical technology, patients pay more attention to the quality of medical services and good service encounters provided by healthcare professionals in order to establish positive patient relationships; hospitals need to improve their own service quality and establish good patient trust relationships so that doctor-patient satisfaction and loyalty can be improved. In a review of related literature, this study found that most past studies focused on issues related of quality of medical services and patient satisfaction, but ignored those related to the relationship between medical service encounters and patient trust and loyalty, as well as the lack of scientific measurement markers for service encounters in the Chinese medical service industry. Therefore, this study uses the Service Encounter Perspective and Service Quality Theory Development Research Scale to collect and analyze data for a typical case of a Chinese tertiary hospital. Finally, this study explores the relationship between the four variables of service quality, service encounter, trust, and loyalty by means of a questionnaire and statistical analysis of the data. Finally, it is concluded that the higher the service quality of the hospital, the higher the customer trust, the higher the service encounter, and in the greater the doctor-patient loyalty.

Low-Carbon Travel Motivation and Constraint: Scales Development and Validation.

Low-carbon travel has emerged as a topic of interest in tourism and academia. Studies have offered reasons tourists may engage in low-carbon travel; however, these explanations are scattered throughout the literature and have yet to be integrated into low-carbon travel motivation and constraint constructs. This study develops a low-carbon travel motivation scale (LCTMS) and a low-carbon travel constraint scale (LCTCS). It performs reliability and validity testing to measure the low-carbon travel motives and obstacles. Items were collected primarily by literature review, and, then, by surveys of 382 tourists from low-carbon travel destinations and 390 from non-low-carbon travel destinations. Through a rigorous scale development process, this study identifies six dimensions of the LCTMS (environmental protection, experience-seeking, escape or social connection, industry pleas and measures for environmental protection, low-carbon products, and green transportation) and four dimensions of the LCTCS (intrapersonal constraints, interpersonal constraints, structural constraints, and the not a travel option).

An integrated model using the Taguchi method and artificial neural network to improve artificial kidney solidification parameters.

BACKGROUND: Hemodialysis mainly relies on the "artificial kidney," which plays a very important role in temporarily or permanently substituting for the kidney to carry out the exchange of waste and discharge of water. Nevertheless, a previous study on the artificial kidney has paid little attention to the optimization of factors and levels for reducing the solidification of the artificial kidney during the hemodialysis procedure. Thus, this study proposes an integrated model that uses the Taguchi method, omega formula, and back-propagation network to determine the optimal factors and levels for addressing this issue. METHODS: First, we collected the recommendations of medical doctors and nursing staff through a small group discussion, and used the Taguchi method to analyze the key factors at different levels. Next, the omega formula was used to convert the analysis results from the Taguchi method to assess the defect rate. Finally, we utilized back-propagation network algorithms to predict the optimal factors and levels for artificial kidney solidification, in order to confirm that the key factors and levels identified can effectively improve the solidification rate of the artificial kidney and thereby enhance the effect of hemodialysis. RESULTS: The research finding proposes the following as the optimal factors and levels for artificial kidney solidification: the amount of anticoagulation should be set at 500 units, the velocity of blood flow at 300 ml/min, the dehydration volume at 2.5 kg, and the vascular access type as autologous blood vessels. We obtained 270 sets of data from the patients of End Stage Renal Disease (ESRD) under the setting of the optimal combination of the factors at different levels; the defect rate of artificial kidney solidification is 12.9%, which is better than the defect rate of 32% in the original experiment. Meanwhile, the patient characteristics for physiological status in BMI, serum calcium, hematocrit, ferritin, and transferrin saturation percentage are improved by this study. CONCLUSION: This conclusion validates the ability of the proposed model in this study to improve the solidification rate of the artificial kidney, thereby confirming the model's use as a standard operation procedure in the hemodialysis experiment. The ideas behind and the implications of the proposed model are further discussed in this study.