Safety improvements from health lean management implementation

2016 ◽  
Vol 33 (8) ◽  
pp. 1150-1178 ◽  
Author(s):  
Maria Crema ◽  
Chiara Verbano
Keyword(s):  
Patient Safety ◽  
Lean Management ◽  
Structured Interviews ◽  
Content Type ◽  
Organizational Issues ◽  
Qualitative Research Methodology ◽  
Multiple Challenges ◽  
Archival Documentation ◽  
Research Stream ◽  
New Research

Purpose In a context where healthcare systems have to face multiple challenges, the development of a methodology that combines new managerial approaches could contribute to pursue and achieve multiple objectives. Inside the research stream that intends to combine health lean management (HLM) and clinical risk management (CRM), the purpose of this paper is to study the significant features that characterize HLM projects obtaining patient safety improvements (L&S projects). Design/methodology/approach The novelty of the research implies to adopt qualitative research methodology, analyzing in-depth case studies. L&S projects at different organizational levels have been selected from the same hospital. Following a research protocol, data have been collected through semi-structured interviews and they have been triangulated studying reports and archival documentation. Findings Comparing the three cases, it emerges that HLM can be a support for CRM since safety improvements can be achieved solving organizational issues. Analyzing the significant features of the three cases, relevant differences have been highlighted among them. At the end, first indications useful for achieving safety improvements from lean project implementation have been grasped. Originality/value This research provides a preliminary contribution to a new research stream that aims to develop a synergic methodology combining HLM and CRM. The first provided indications can be followed by hospital managers who wish to learn how to implement projects achieving patient safety improvements besides efficiency enhancement. After testing and exploiting the obtained results, a new methodology should be developed moving toward a safer and more sustainable healthcare system.

Investigating the connections between health lean management and clinical risk management

2015 ◽  
Vol 28 (8) ◽  
pp. 791-811 ◽  
Author(s):  
Maria Crema ◽  
Chiara Verbano
Keyword(s):  
Risk Management ◽  
Patient Safety ◽  
Design Methodology ◽  
Lean Management ◽  
Clinical Risk Management ◽  
Content Type ◽  
Clinical Risk ◽  
Research Stream ◽  
The Relationship ◽  
Practical Implications

Purpose – The purpose of this paper is to investigate connections and overlaps between health lean management (HLM) and clinical risk management (CRM) understanding whether and how these two approaches can be combined together to pursue efficiency and patient safety improvements simultaneously. Design/methodology/approach – A systematic literature review has been carried out. Searching in academic databases, papers that focus not only on HLM, but also on clinical errors and risk reduction, were included. The general characteristics of the selected papers were analysed and a content analysis was conducted. Findings – In most of the papers, pursing objectives of HLM and CRM and adopting tools and practices of both approaches, results of quality and, particularly, of safety improvements were obtained. A two-way arrow between HLM and CRM emerged but so far, none of the studies has been focused on the relationship between HLM and CRM. Originality/value – Results highlight an emerging research stream, with many useful theoretical and practical implications and opportunities for further research.

Has Lean improved organizational decision making?

2016 ◽  
Vol 29 (5) ◽  
pp. 536-549 ◽  
Author(s):  
Pascale Simons ◽  
Jos Benders ◽  
Jochen Bergs ◽  
Wim Marneffe ◽  
Dominique Vandijck
Keyword(s):  
Decision Making ◽  
Design Methodology ◽  
Lean Management ◽  
Structured Interviews ◽  
Organizational Decision Making ◽  
Content Type ◽  
Organizational Contexts ◽  
Sustainable Improvement ◽  
Care Processes ◽  
Practical Implications

Purpose – Sustainable improvement is likely to be hampered by ambiguous objectives and uncertain cause-effect relations in care processes (the organization’s decision-making context). Lean management can improve implementation results because it decreases ambiguity and uncertainties. But does it succeed? Many quality improvement (QI) initiatives are appropriate improvement strategies in organizational contexts characterized by low ambiguity and uncertainty. However, most care settings do not fit this context. The purpose of this paper is to investigate whether a Lean-inspired change program changed the organization’s decision-making context, making it more amenable for QI initiatives. Design/methodology/approach – In 2014, 12 professionals from a Dutch radiotherapy institute were interviewed regarding their perceptions of a Lean program in their organization and the perceived ambiguous objectives and uncertain cause-effect relations in their clinical processes. A survey (25 questions), addressing the same concepts, was conducted among the interviewees in 2011 and 2014. The structured interviews were analyzed using a deductive approach. Quantitative data were analyzed using appropriate statistics. Findings – Interviewees experienced improved shared visions and the number of uncertain cause-effect relations decreased. Overall, more positive (99) than negative Lean effects (18) were expressed. The surveys revealed enhanced process predictability and standardization, and improved shared visions. Practical implications – Lean implementation has shown to lead to greater transparency and increased shared visions. Originality/value – Lean management decreased ambiguous objectives and reduced uncertainties in clinical process cause-effect relations. Therefore, decision making benefitted from Lean increasing QI’s sustainability.

Internationalization challenges for SMEs: evidence and theoretical extension

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ashna Ashwini Chandra ◽  
Justin Paul ◽  
Meena Chavan
Keyword(s):  
Entrepreneurial Orientation ◽  
Qualitative Method ◽  
Institutional Environment ◽  
Structured Interviews ◽  
Content Type ◽  
International Performance ◽  
Purposeful Sampling ◽  
Multiple Case ◽  
New Research ◽  
The Relationship

Purpose The paper aims to examine new research on the internationalization of small- and medium-sized enterprises (SMEs) in Pacific Island Nation country Fiji. Design/methodology/approach A multiple case qualitative method was used which adopted a purposeful sampling methodology through semi-structured interviews to test propositions and present preliminary findings. Findings The authors find that, SME internationalization in Fiji is driven by management competence (MC) and entrepreneurial orientation (EO) and is hindered by the unfavourable institutional environment. The authors then develop a conceptual model and propositions to further explore these enablers and the inhibitors of Fiji SME internationalization. The authors’ findings have important implications for managers in improving their firms’ international performance. Originality/value This is a pioneering effort to evaluate the relationship between the factors of EO, MC and institutional distance and their impact on the international performance of SMEs. This paper contributes to the existing literature on international entrepreneurship through the examination of SMEs’ internationalization activities in Fiji.

Developing knowledge from entrepreneurial actions – toward a taxonomy

2017 ◽  
Vol 24 (4) ◽  
pp. 793-813
Author(s):  
Sihem Ben Mahmoud-Jouini ◽  
Thomas Paris ◽  
Sylvain Bureau
Keyword(s):  
A Priori ◽  
Logical Necessity ◽  
Structured Interviews ◽  
Entrepreneurial Learning ◽  
Content Type ◽  
Daily Experience ◽  
Fine Grained ◽  
Secondary Sources ◽  
Making Sense ◽  
Archival Documentation

Purpose The purpose of this paper is to enrich our understanding of entrepreneurs’ daily deeds, tasks and activities. The research investigates the ways in which entrepreneurs seize opportunities and gain knowledge from the start to the expansion of their ventures. Design/methodology/approach Two case studies were developed based on a longitudinal fine-grained analysis of two ventures over two years. Entrepreneurs’ success and learning were modeled in line with grounded theory methodology. Data were collected from both primary and secondary sources in the form of semi-structured interviews and archival documentation. Findings The authors develop an original conceptual framework that consists of ten entrepreneurial learning opportunities and four knowledge development modes. There are ten generic types of actions that entrepreneurs take. There are then four distinctive ways to transform these experiences into knowledge. The model is assessed in absolute terms and relatively to existing taxonomies. Research limitations/implications The findings question the premises on which entrepreneurial learning research traditionally relies. Opportunities can be open-ended rather than purely instrumental. Similarly, knowledge can be emerging as much as it can be espoused. This opens-up space for further research. Practical implications For practitioners, the findings suggest new ways for making sense of the daily experience of their entrepreneurial endeavor. The learning modes suggested can be used by coaches and mentors when helping entrepreneurs in their venture. Originality/value The research provides empirical evidence of what entrepreneurs do. This may help cast traditional debates about what there is to do (logical necessity) and what there is to know (a priori knowledge) in a new light.

scholarly journals The impact of temporary staff on permanent staff in accident and emergency departments

2019 ◽  
Vol 6 (1) ◽  
pp. 2-18 ◽  
Author(s):  
Zofia Bajorek ◽  
David Guest
Keyword(s):  
Patient Safety ◽  
Service Quality ◽  
Emergency Departments ◽  
Job Demands ◽  
Temporary Workers ◽  
Structured Interviews ◽  
Content Type ◽  
Accident And Emergency ◽  
Permanent Staff ◽  
The Impact

Purpose The purpose of this paper is to address a gap in the recent literature on employment of temporary workers by exploring the impact of temporary workers on the perceptions, attitudes and behaviour of permanent staff with particular reference to their implications for patient safety and service quality in hospital accident and emergency departments. The analysis is set in the context of the job demands-resources theory. Design/methodology/approach The research was undertaken using a case study approach with semi-structured interviews in two London hospitals. Participants included staff from the HR director level, clinical managers and permanent staff who all had an influence in the hiring and management of temporary staff in some way. Transcripts were analysed thematically using an adopted framework approach. Findings The results indicate that the effect of temporary staff on permanent staff depended on the quality of the “resource”. There was a “hierarchy of preference” for temporary staff based on their familiarity with the context. Those unfamiliar with the department served as a distraction to permanent staff due to the need to “manage” them in various ways. While this was rarely perceived to affect patient safety, it could have an impact on service quality by causing delays and interruptions. In line with previous research, the use of temporary staff also affected perceptions of fairness and the commitment of some permanent staff. Practical implications A model developing an approach for improved practice when managing temporary staff was developed to minimise the risks to patient safety and service quality, and improve permanent staff morale. Social implications The review highlights the difficulties that a limited amount of temporary staff integration can have on permanent staff and patient care, indicating that consideration must be placed on how temporary staff are inducted and clarifying expectations of roles for both temporary and permanent staff. Originality/value This paper studies the under-researched impact of temporary staff, and, distinctively, staff employed on a single shift, on the behaviour and attitudes of permanent staff. It highlights the need to consider carefully the qualitative nature of “resources” in the job demands-resources theory.

The perception of non-Muslim tourists towards halal tourism

2018 ◽  
Vol 9 (4) ◽  
pp. 823-840 ◽  
Author(s):  
Mohamed Battour ◽  
Fatemeh Hakimian ◽  
Mohd Ismail ◽  
Erhan Boğan
Keyword(s):  
Design Methodology ◽  
Qualitative Data ◽  
Destination Marketing ◽  
Structured Interviews ◽  
Content Type ◽  
New Research

Purpose This paper aims to explore the perceptions of non-Muslim tourists towards halal tourism in Malaysia and Turkey. It also investigates the extent to which non-Muslim tourists are willing to purchase certain types of halal products and services. Design/methodology/approach Qualitative data were collected by conducting 35 semi-structured interviews with non-Muslim tourists in Malaysia and another 25 in Turkey. Findings Six major aspects are identified that describe the perceptions of non-Muslim tourists towards halal tourism. This paper also provides some suggestions for destination marketers on how best to cater for Western tourists and increase international arrivals. Originality/value This paper explores the perceptions of non-Muslim tourists towards halal tourism which is totally new research in destination marketing. It provides some original insights into the interactions between the religion of Islam and non-Muslim tourists. The insight should be of value to authorities, the industry and academics in both the Muslim and non-Muslim worlds.

scholarly journals Challenges in disaster relief operations: evidence from the 2017 Kermanshah earthquake

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Amin Maghsoudi ◽  
Mohammad Moshtari
Keyword(s):  
Social Media ◽  
Disaster Relief ◽  
Primary Data ◽  
Minor Role ◽  
Structured Interviews ◽  
Content Type ◽  
Disaster Relief Operations ◽  
Modelling Studies ◽  
Multiple Challenges ◽  
Relief Operations

PurposeThis paper identifies the challenges during a recent disaster relief operation in a developing country where the humanitarian response is dominated by national actors, with international actors having a minor role.Design/methodology/approachA case study design is used; the main data sources are semi-structured interviews with 43 informants involved in the 2017 Kermanshah earthquake relief operation.FindingsThe findings suggest that humanitarian practitioners deal with multiple challenges during disaster relief operations. One group of challenges relates to humanitarian logistics (HL) like needs assessment, procurement, warehousing, transportation and distribution, all widely discussed in the literature. Another involves the growing use of social media, legitimacy regulations and the engagement of new humanitarian actors (HAs) like social media activists and celebrities. These factors have not been extensively studied in the literature; given their growing influence, they require more scholarly attention.Practical implicationsThe findings will help humanitarian practitioners and policymakers better understand the challenges involved in disaster relief operations conducted by multiple actors and thus help them improve their practices, including the creation of proper regulations, policies and logistics strategies.Originality/valueThe study uses primary data on a recent disaster to assess and extend the findings of previous studies regarding HL challenges. It also elaborates on the critical non-logistical challenges that influence aid delivery in emergency responses, including the growth of social media, regulations and the engagement of new HAs. The results may motivate future empirical and modelling studies to investigate the identified challenges and identify practices to mitigate them.

Robotizing shared service centres: key challenges and outcomes

2020 ◽  
Vol 31 (1) ◽  
pp. 157-178
Author(s):  
Alcidio Silva Figueiredo ◽  
Luisa Helena Pinto
Keyword(s):  
Institutional Theory ◽  
Management Practices ◽  
Positive Impact ◽  
Project Managers ◽  
Structured Interviews ◽  
Service Workers ◽  
Content Type ◽  
Shared Service ◽  
Internal Mobility ◽  
New Research

PurposeThe introduction of robotic process automation (RPA) in shared service centres (SSCs) can hardly be overlooked. This article, therefore, draws on the institutional theory to widen the understanding of its implementation and outcomes regarding people management. Drawing on the lens of the institutional theory and the literature on SSCs and RPA, this study addresses the key challenges and outcomes of robotization.Design/methodology/approachThe study follows a qualitative approach and a purposeful sampling design that collected data from six major SSCs) introducing robotization. Data were collected from semi-structured interviews with service representatives, including RPA project managers. A thematic content analysis was used.FindingsThe introduction of robotics follows mechanisms of coercive, normative and mimetic isomorphism and is effectively replacing workers. So far, this process has been managed through a few reactive people management practices, such as earlier retirements, internal mobility and outsourcing reduction, which warns of future tensions. The findings also show the emergence of new jobs, such as robot developers and robot managers.Originality/valueThe paper contributes to the limited empirical body of research in RPA in SSCs. The study is novel as it is one of the first offering an implementation roadmap for other SSCs and illustrates the positive impact on processes redesign. It also provides empirical evidence on the debate about the potential for service workers' replacement versus tasks augmentation. In the longer term, this study opens new research avenues related to the tensions and contradictions from the progressive institutionalization of robotization in service organizations.

Trajectories of influential conceptual articles in service research

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Loic Pengtao Li ◽  
Julia A. Fehrer ◽  
Roderick J. Brodie ◽  
Biljana Juric
Keyword(s):  
Knowledge Diffusion ◽  
Integrated Approach ◽  
Research Field ◽  
Customer Engagement ◽  
Service Research ◽  
Future Research ◽  
Content Type ◽  
Anchor Points ◽  
Research Stream ◽  
New Research

PurposeThe purpose of this study is to diagnose the trajectory of influential conceptual articles in developing a research stream. The authors uncover the knowledge diffusion through influential conceptual articles and identify characteristics that make conceptual articles influential in their field.Design/methodology/approachThis study draws on scientometrics, specifically an integrated approach combining quantitative citation counts with qualitative citation practices analysis that offers a comprehensive understanding of the nature and context of citations. The authors use the case of customer engagement – a prominent contemporary marketing and service research stream – to explore the trajectory of influential articles in shaping a new research stream.FindingsThis research shows that influential articles contribute to the reciprocal knowledge diffusion within and outside their home discipline. They provide anchor points for conceptual framing, conceptual refining and conceptual reconciliation – three application patterns of citations that are pivotal to navigate theory discovery and theory justification in a research field.Research limitations/implicationsThe study analyzes the early impact period of two influential customer engagement articles to understand the developments leading to the establishment of a new research stream. Future research drawing on automated citation and bibliometric methods may consider extended time periods.Originality/valueThis study traces the trajectory of influential articles in marketing and service research. The authors identify characteristics of influential conceptual articles, and recommend practices to develop a conceptual paper with the potential for an influential trajectory. It shows that while marketing and service research has a tradition of “borrowing” theories from other fields, seminal articles “lend” theories to other fields.

scholarly journals Linking employee empowerment with productivity in off-site construction

2015 ◽  
Vol 22 (1) ◽  
pp. 21-37 ◽  
Author(s):  
Faisal Alazzaz ◽  
Andrew Whyte
Keyword(s):  
Current Knowledge ◽  
Case Study Research ◽  
Employee Empowerment ◽  
Structured Interviews ◽  
Data Set ◽  
Actual Performance ◽  
Content Type ◽  
Construction Productivity ◽  
The One ◽  
New Research

Purpose – The purpose of this paper is to address current knowledge gaps in off-site sub-element fabrication efficiency factors, by identifying an explicit relationship between productivity and employee empowerment. Design/methodology/approach – The research is based on two engineering fabrication-yard case studies that investigate both qualitatively (via analysis of semi-structured interviews that incorporate a five-point Likert scale, with fabrication-product stakeholders), and also quantitatively (via assessment using SPSS statistical analyses to determine significance and trends in the data-set) the relationship between empowerment and productivity. Findings – The results reveal a positive linear relationship in off-site construction between “employee empowerment factors” and, explicitly fabrication-yard “productivity-levels”. An especially strong and significant positive correlation is found to exist in resource development, worker involvement, process improvement, and task recognition as they refer to off-site construction productivity. Practical implications – Most academic studies of off-site construction remain largely anecdotal and lack an empirical objective study; as a result, this (fabrication-yard) case-study research provides a useful approach to measure empirically the link between employee empowerment and productivity of off-site construction. Originality/value – Employee empowerment in the construction industry has long been a focus of analyses; however, there remains a lack of consensus and very few studies into the direct relationship between employee empowerment on the one-hand, and productivity in off-site construction on the other-hand. It is argued here that the on-going new research undertaken in the present study will go beyond subjective opinion towards objective measurement of actual performance in off-site construction.

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