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Evaluating primary care for children has not before been undertaken on a national level, and only infrequently on an international level, an adult-focused perspective is the norm. The Models of Child Health Appraised (MOCHA) project explored the evaluation of quality of primary care for children in a nationally comparable way, which recognises the influence of all components of child well-being and well-becoming. Using adult-focused metrics fails to account for children’s physical and psycho-social development at different ages, differences in health and non-health determinants, patterns of disease and risk factors and the stages of the life course. To do this, we attempted to identify comparable measures of child health in the European Union and European Economic Area countries, we aimed to perform a structural equation modelling technique to identify causal effects of certain policies or procedures in children’s primary care and we aimed to identify and interrogate large datasets for key tracer conditions. We found that the creation of comparative data for children and child health services remains a low priority in Europe, and the largely unmet need for indicators covering all the healthcare dimensions hampers development of evidence-based policy. In terms of the MOCHA project objective of appraising models of child primary health care, the results of this specific work show that the means of appraisal of system and service quality are not yet agreed or mature, as well as having inadequate data to fuel them.

In order to assess the state of health of Europe’s children, or to appraise the systems and models of healthcare delivery, data about children are essential, with as much precision and accuracy as possible by small group characteristic. Unfortunately, the experience of the Models of Child Health Appraised (MOCHA) project and its scientists shows that this ideal is seldom met, and thus the accuracy of appraisal or planning work is compromised. In the project, we explored the data collected on children by a number of databases used in Europe and globally, to find that although the four quinquennial age bands are common, it is impossible to represent children aged 0–17 years as a legally defined group in statistical analysis. Adolescents, in particular, are the most invisible age group despite this being a time of life when they are rapidly changing and facing increasing challenges. In terms of measurement and monitoring, there is little progress from work of nearly two decades ago that recommended an information system, and no focus on the creation of a policy and ethical framework to allow collaborative analysis of the rich anonymised databases that hold real-world people-based data. In respect of data systems and surveillance, nearly all systems in European society pay lip service to the importance of children, but do not accommodate them in a practical and statistical sense.

This paper aims to systematically review the literature on roles of physicians in virtual teams (VTs) delivering healthcare for effective “physician e-leadership” (PeL) and implementation of e-health.

The analyzed studies were retrieved with explicit keywords and criteria, including snowball sampling. They were synthesized with existing theoretical models on VT research, healthcare team competencies and medical leadership.

Six domains for further PeL inquiry are delineated: resources, task processes, socio-emotional processes, leadership in VTs, virtual physician-patient relationship and change management. We show that, to date, PeL studies on socio-technical dynamics and their consequences on e-health are found underrepresented in the health literature; i.e. no single empirical, theoretic or conceptual study with a focus on PeL in virtual healthcare work was identified.

E-health practices could benefit from organization-behavioral type of research for discerning effective physicians’ roles and inter-professional relations and their (so far) seemingly modest but potent impact on e-health developments.

Although best practices in e-health care have already been identified, this paper shows that physicians’ roles in e-health initiatives have not yet received any in-depth study. This raises questions such as are physicians not yet sufficiently involved in e-health? If so, what (dis)advantages may this have for current e-health investments and how can they best become involved in (leading) e-health applications’ design and implementation in the field?

If effective medical leadership is being deployed, e-health effectiveness may be enhanced; this new proposition needs urgent empirical scrutiny.

The purpose of this paper is to present a description of the Irish national clinical governance development initiative and an evaluation of the initiative with the purpose of sharing the learning and proposing actions to activate structures and processes for quality and safety. The Quality and Patient Safety Division of the Health Service Executive established the initiative to counterbalance a possible focus on finances during the economic crisis in Ireland and bring attention to the quality of clinical care.

A clinical governance framework for quality in healthcare in Ireland was developed to clearly articulate the fundamentals of clinical governance. The project plan involved three overlapping phases. The first was designing resources for practice; the second testing the implementation of the national resources in practice; and the third phase focused on gathering feedback and learning.

Staff responded positively to the clinical governance framework. At a time when there are a lot of demands (measurement and scrutiny) the health services leads and responds well to focused support as they improve the quality and safety of services. Promoting the use of the term “governance for quality and safety” assisted in gaining an understanding of the more traditional term “clinical governance”. The experience and outcome of the initiative informed the identification of 12 key learning points and a series of recommendations

The initial evaluation was conducted at 24 months so at this stage it is not possible to assess the broader impact of the clinical governance framework beyond the action project hospitals.

The single most important obligation for any health system is patient safety and improving the quality of care. The easily accessible, practical resources assisted project teams to lead changes in structures and processes within their services. This paper describes the fundamentals of the clinical governance framework which might serve as a guide for more integrative research endeavours on governance for quality and safety.

Experience was gained in both the development of national guidance and their practical use in targeted action projects activating structures and processes that are a prerequisite to delivering safe quality services.

Modern technologies are seen as an essential component of the fourth industrial revolution (industry 4.0) and their adoption is vital to transform the existing manufacturing system into industry 4.0-based manufacturing system. Therefore, the primary objective of this research explores the barriers of modern technology adoption and their mitigating solutions in order to align with Industry 4.0 objectives.

Barriers to adopting modern technologies and respective mitigating solutions are identified from the available literature. Further, these barriers are ranked with the help of expert opinions by using the BWM method appropriately. The identified solutions are ranked using the combined compromise solution (CoCoSo) method.

Several modern technologies and their capabilities are recognised to support the industry 4.0-based manufacturing systems. This study identifies 22 barriers to the effective adoption of modern technologies in manufacturing and 14 solutions to overcome these barriers. Change management, the high initial cost of technology and appropriate support infrastructure are the most significant barriers. The most prominent solutions to overcome the most considerable barriers are ‘supportive research, development and commercialisation environment’, ‘updated policy and effective implementation’ and ‘capacity building through training’ that are the top three solutions that need to be addressed.

The barriers and solutions of modern technology adoption are obtained through a comprehensive literature review, so there is a chance to ignore some significant barriers and their solutions. Furthermore, ranking barriers and solutions is done with expert opinion, which is not free from biases.

This identification and prioritisation of barriers will help managers to understand the barriers so they can better prepare themselves. Furthermore, the suggested solutions to overcome these barriers are helpful for the managers and could be strategically adopted through optimal resource utilisation.

This study proposes a framework to identify and analyse the significant barriers and solutions to adopting modern technologies in the manufacturing system. It might be helpful for manufacturing organisations that are willing to transform their manufacturing system into industry 4.0.