Högskolan i Skövde

This chapter summarises findings from an empirical study investigating how digital healthcare solutions should be developed to satisfy individual demands for understanding and managing healthcare information and activities. Despite the quick development of new digital healthcare services to accomplish service efficiency and cost-effectiveness, and at the same time supporting the achievement of a wide range of sustainable development goals, some users perceive challenges due to different age-related, physical, and cognitive starting points. The chapter offers a broad view of the development of digital healthcare solutions and considers literature and the perspectives of technologists, caregivers, and users through a qualitative approach using interviews and autoethnography. A main finding is that the development of digital healthcare solutions that enhance health literacy needs a comprehensive strategy, in which users, healthcare providers, family members, and other stakeholders should participate.

European higher education institutions (HEIs) are facing increasing demands for more flexible learning and flexibility in learning paths.

This report from a 2023 European University Association Learning & Teaching Thematic Peer Group on “Flexible learning and teaching” explores the complexity of implementing flexible learning at HEIs, starting by defining what it means and entails for the institution, and its members and entities (staff, students, leadership, faculties). With the view that the development of flexible learning is an essential condition for the future of learning at universities, the group identified challenges and examples of practice, and offered recommendations for institutions to reflect on their strategy and build capacity for flexible learning.

This paper presents results from a simulation case study analyzing care strategies for elderly patients in a regional healthcare system (HCS) in Sweden. Three strategies to reduce emergency visits, hospitalisations, and stays were evaluated: care coordinators at emergency departments, mobile health clinics visiting fragile patients in their homes, and proactive primary care. Using system dynamics modelling and empirical data, the impact on the regional HCS was explored considering the reduced care demand and demographic changes. Subsequently, the impact on the population's health status was assessed. Combining strategies yielded the best outcome, but improving patients' health status may increase long-term care demand. The study emphasizes the importance of implementing these strategies to offer better care for elderly patients and reduce healthcare costs. Findings highlight the potential long-term effects of improving health status and the need for a comprehensive approach to address the evolving care demands of an ageing population.

Digitalization is forcing the industry to rethink current practices in all business domains, pushing for a digital transformation of business and operations at a high rate and, thus, paving the way for new business models and making others redundant. For small and medium-sized companies (SME), in particular, it is an enormous challenge to keep up with the pace of technological development. Several initiatives have argued the industry’s need for continuous digitalization, innovation, transformation ability, and future skills and competencies development. However, the advancement of the Swedish industry in this area has been uneven, where larger organizations have begun their digital transformation journey to some extent, but SMEs risk falling behind. In addition to the technological transformation, the challenges regarding the industries’ skills supply need to be solved, where a workforce with the right competencies, knowledge, and skill sets are equally, if not more, important for remaining competitive. One of the key elements to face these challenges in the companies will be to recruit knowledgeable employees or re-skill the existing ones. Efficient access to relevant knowledge and skills is still a major concern for companies that will surely affect their competitiveness for a long time to come. This paper elaborates on the opportunities and challenges that Swedish universities face in the context of lifelong learning and education for industry professionals. The paper presents results and experiences gained from a lifelong learning project for industry professionals at the University of Skövde in collaboration with ten industry partners. The results from the project show that in addition to pedagogical methods, current structures and policies within academia need to be further developed to effectively serve industry professionals. The paper also presents a concept of education for industry professionals in the lifelong learning context based on the results and experience gained from the project.

The expected demographic changes, and especially the rise in life expectancy, will considerably increase elderly patients' demand for healthcare. There are different strategies that can offer better care for these patients, reduce their unnecessary visits to the emergency departments, and in consequence, reduce the number of hospitalizations and days at the hospital. This study employed system dynamics to analyze the economic and quality-related effects of different closer care strategies such as investments in care coordinators and mobile health clinics, as well as to offer proactive care in the primary care facilities for elderly patients. The results indicate that a combination of the different strategies will support better care for patients, will reduce hospital costs and will reduce the existing pressure on the emergency department. The paper also reflects on the process followed to conduct the study and the lessons learned. 

Lean is and will still be one of the most popular management philosophies in the Industry 4.0 context and simulation is one of its key technologies. Many authors discuss about the benefits of combining Lean and simulation to better support decision makers in system design and improvement. However, there is a lack of reviews in the domain. Therefore, this paper presents a four-stage comprehensive review and analysis of existing literature on their combination. The aim is to identify the state of the art, existing methods and frameworks for combining Lean and simulation, while also identifying key research perspectives and challenges. The main trends identified are the increased interest in the combination of Lean and simulation in the Industry 4.0 context and in their combination with optimisation, Six Sigma, as well as sustainability. The number of articles in these areas is likely to continue to grow. On the other hand, we highlight six gaps found in the literature regarding the combination of Lean and simulation, which may induce new research opportunities. Existing technical, organisational, as well as people and culture related challenges on the combination of Lean and simulation are also discussed.

The rapid changes in the market including globalization, the requirement for personalizedproducts and services by the customers, shorter product life-cycles, the exponential growthof technological advances, and the demographical changes, will demand organizations toeffectively improve and design their systems in order to survive. This is the actual paradigmcharacterizing the industrial and service sectors. This scenario presents a considerablechallenge to decision makers who will need to decide about how to design and improve amore than ever complex system without compromising the quality of the decision taken.Lean, being a widely applied management philosophy with very powerful principles, itsmethods and tools are static in nature and have some limitations when it comes to the designand improvement of complex and dynamic systems. Some authors have proposed thecombined use of simulation with Lean in order to overcome these limitations. Furthermore,optimization and post-optimization tools coupled to simulation, provide knowledge aboutoptimal or nearly optimal system configurations to choose from. However, even if Leanprinciples, methods and tools, as well as simulation and optimization, pursue the objectiveof supporting organizations regarding system design and improvement, a bilateral approachfor their combination and its benefits have barely been addressed in the literature.Many studies focus only on how specific Lean tools and simulation can be combined, treatingLean purely as a toolbox and not considering how Lean can support the simulation process.The aim of this research is to address this knowledge gap by analyzing the mutualbenefits and presenting a framework for combining Lean, simulation and optimization tobetter support decision makers in system design and improvement where the limitationsof Lean tools and simulation are overcome by their combination. This framework includesa conceptual framework explaining the relationships between the Lean philosophy, methodsand tools with simulation and optimization; the purposes for this combination and stepby step processes to achieve these purposes; the identification of the roles involved in eachprocess; a maturity model providing guidelines on how to implement the framework; existingbarriers for the implementation; and ethical considerations to take into account. Anindustrial handbook has also been written which explains how to deploy the framework.The research has been conducted in three main stages including an analysis of the literatureand the real-world needs, the definition and formulation of the framework, and finally, itsevaluation in real-world projects and with subject matter experts. The main contributionof this research is the reflection provided on the bilateral benefits of the combination, aswell as the defined and evaluated framework, which will support decision makers take qualitydecisions in system design and improvement even in complex scenarios.

De snabba förändringarna på marknaden såsom globalisering, ökat krav på personliga produkteroch tjänster från kunderna, kortare produktlivscykler, tekniska framsteg med exponentielltillväxt samt demografiska förändringar medför ökat krav på att organisationer effektivtförbättrar och utformar sina system. Detta är det nuvarande paradigmet som karaktäriserarindustri- och tjänstesektorerna. Det är ett scenario som utgör en stor utmaningför beslutsfattare, vilka kommer att behöva ta beslut i än mer komplexa system där det blirsvårare att utforma och förbättra system med bibehållen kvalitet. Lean är en allmänt tilllämpadproduktionsfilosofi med kraftfulla principer, med metoder och verktyg som är statiskatill sin natur vilka har begränsningar när det gäller utformning och förbättring avkomplexa och dynamiska system. En del författare har föreslagit den kombinerade användningenav simulering med Lean för att övervinna dessa begränsningar. Dessutom erbjudersimulering kombinerat med optimering och postoptimeringsverktyg genererandet av kunskapom optimala eller nästan optimala systemkonfigurationer. Även om både Lean-principermed dess metoder och verktyg och simulering syftar till att stödja organisationer vidutformning och förbättring av sina system tar litteraturen upp få fördelar med ett kombinerattillvägagångssätt. Flera studier fokuserar endast på hur specifika verktyg inom Leankan kombineras med simulering men behandlar inte hur Lean som filosofi kan stödja simuleringsprocessen.Syftet med denna forskning är att ta itu med denna kunskapsluckagenom att analysera fördelar med kombinationen Lean, simulering och optimering, samtbeskriva hur dess svagheter var för sig kan överbryggas när de kombineras. Resultatet presenterasi ett ramverk med beskrivning av dess genomförande, vilket syftar till att genereraett bättre beslutsstöd vid utformning och förbättring av komplexa och dynamiska system.Ramverket innefattar ett konceptuellt ramverk som förklarar relationerna mellan Lean-filosofin,dess metoder och verktyg, med simulering och optimering; olika ändamål för kombinationenbeskrivs, samt genomgång av steg för steg processer ges för att uppnå dessaändamål; identifiering av de roller som är inblandade i varje process beskrivs; en mognadsmodellpresenteras som ger riktlinjer för hur man implementerar ramverket; befintligahinder för genomförandet och etiska överväganden att ta hänsyn till lyfts också fram. Slutligenhar en industriell handbok skrivits som förklarar hur man ska implementera ramverket.Forskningen har genomförts i tre faser, bland annat en behovsanalys utifrån litteraturenoch verkliga projekt, definitionen av ramverket, och avslutningsvis utvärderas det genomverkliga projekt och med ämnesexperter. Huvudbidraget för denna forskning är reflektionenöver det extra utbytet med kombinationen Lean, simulering och optimering medXIIdess fördelar, vilket bygger på det framtagna ramverket och dess utvärdering. Där ramverkethar för avsikt att stödja beslutsfattare att fatta kvalitetsbeslut vid utformning och identifieringav förbättringar i sina system även i komplexa scenarier.

The highly competitive automobile market requires automotive companies to become efficient by continuously improving their production systems. This paper presents a case study where simulationbased optimization (SBO) was employed as a step within a Value Stream Mapping event. The aim of the study was to promote the use of SBO to strengthen the continuous improvement work of the company. The paper presents all the key steps performed in the study, including the challenges faced and a reflection on how to introduce SBO as a powerful tool within the lean continuous improvement standards.

Is it beneficial to combine lean, simulation and optimization? And if so, how can they be combined for decision-making support in system design and improvement? This research proposes a framework that sets the basis for achieving beneficial interactions between the lean philosophy, methods and tools, and simulation-based optimization. A framework that gives the users the possibility to get better system understanding, conduct a deeper system analysis, and attain an optimal system design and improvement, and thereby, get better foundation for sustainable long time improvement. The framework has been tested in several realworld case studies. Moreover, surveys have been conducted to evaluate the perception of subject matter experts about its usefulness, as well as its usability and perceived quality by end users and decision makers, all of them reporting very positive results.

The new industrial revolution brings important changes to organizations that will need to adapt their machines, systems and employees’ competences to sustain their business in a highly competitive market. Management philosophies such as lean will also need to adapt to the improvement possibilities that Industry 4.0 brings. This paper presents a review on the role of lean and simulation in the context of Industry 4.0. Additionally, the paper presents a conceptual framework where simulation and optimization will make the lean approach more efficient, speeding up system improvements and reconfiguration, by means of an enhanced decision-making process and supported organizational learning.