Two-Lenses Model to Unfold Sustainability Innovations: A Tool Proposal from Sustainable Business Model and Performance Constructs

This research combines corporate sustainability performance and sustainable business model concepts to improve the corporate sustainability of organizations. The main objective of this article is to propose and apply a tool to identify sustainable innovation opportunities through a structured brainstorming process while providing a systemic business perspective and a strong multi-stakeholder orientation. The present qualitative research was carried out in two phases. The first phase consisted of a critical analysis of literature that enabled the proposition of the Two-Lenses Model (2LM) for sustainability innovation. The corporate sustainability performance lens encompasses strategic drivers, business processes, capabilities, stakeholders’ satisfaction and contributions. The sustainable business models lens considers value proposition, value creation and delivery system and value capture and sharing. The second phase consists of applying the 2LM in two industrial cases. The results show that the proposed model has the potential to trigger the identification of opportunities through two mechanisms: misalignments between performance dimensions and gaps in stakeholder satisfaction. Further research opportunities lie on deepening into these findings and investigating the implementation process for the identified innovation opportunities.

Identification of waste: DOWNTIME in the outpatient prescription services at the pharmacy installation of Rumah Sakit Islam Siti Hajar Mataram

Background: The hospital pharmacy installation is a health service unit that is required to provide professional services and improve quality which is oriented towards achieving patient satisfaction. Waste identification in pharmaceutical services is important because it has an impact on stakeholder satisfaction. Objective: Identifying waste using the DOWNTIME method for the outpatient prescription services at the pharmacy installation of Rumah Sakit Islam Siti Hajar Mataram. Methods: The study used the cross-sectional design, with the population being all outpatients who were provided with pharmaceutical services during February – April 2019 as well as all staff. Data were tabulated and analyzed descriptively. Critical waste was obtained through questionnaires and the root causes of critical waste were obtained through in-depth interviews with 5-why methods. Results: Waste waiting had the highest rate compared to other wastes, reaching 44% or 53 out of 121 respondents, followed by inventory (26%), extra processing (19%), transportation (14%), defects (14%), motion (13%), over production (8%), and non-utilized skills (7%). Meanwhile, from the staff respondents, waiting was also the highest waste (18%), followed by inventory (16%), motion (13%), over production (12%), transportation (12%), non-utilized skills (10%), extra processing (10%), and defects (9%). The root cause of waste waiting was the frequent drug unavailability due to delays in payment of services from the cooperating party to the hospital as well as the narrow service areas. Conclusion:Waste waiting became the critical waste with the highest percentage of dissatisfaction in the patient respondents (44%) and staff respondents (18%). Keywords: Waste, DOWNTIME, outpatient prescription services, pharmacy installation of RSI Siti Hajar Mataram

Assessing stakeholder satisfaction in PPP transport projects in developing countries: evidence from Vietnam

PurposePublic-Private Partnership (PPP) model still contains the obstacle in partnership, which can lead to different satisfaction between project participants. Therefore, project managers need to consider stakeholder satisfaction to ensure success in PPP implementation. However, this problem is limited in the previous studies in developing countries. The purpose of this study is to evaluate stakeholder satisfaction of PPP transport projects in developing countries.Design/methodology/approachA total of 15 satisfaction factors were identified and four main groupings were introduced by a review of the literature and expert interview rounds, including satisfaction of general public, satisfaction of private sector, satisfaction of government and satisfaction of end-users. A PPP expressway project in Vietnam was used to illustrate for this analysis. Data were collected through a questionnaire survey with 31 validated responses. The fuzzy synthetic evaluation method was then applied to evaluate satisfaction index for the stakeholder satisfaction of PPP transport projects in Vietnam as a developing country.FindingsThe analyzed result showed that the project participants are basically satisfied with gained outcomes of the experimental project with the satisfaction index = 3.46. Specifically, the general public expressed that they are “satisfied” with satisfaction index = 4.08. Meanwhile, end-users, government and private sector are “basically satisfied” with the project outcome (the satisfaction index of 3.31, 3.16 and 3.04, respectively).Originality/valueThis study provides more depth understanding of the satisfaction factor with transport infrastructure service in developing countries through PPP procurement. In addition, the decision-makers might utilize this evaluation model for rating the stakeholder satisfaction of real PPP projects to ensure project success.

102 Virtual family-centered rounds: A collaborative necessity during COVID-19 and beyond

Primary Subject area Hospital Paediatrics Background Family-centered rounds (FCR) are the cornerstone of pediatric hospital care and have many proven benefits including improved patient outcomes, satisfaction, communication and safety. Traditionally, FCR take place in the patient’s room; however, due the COVID-19 pandemic, entering patient rooms was no longer advisable in order to maintain physical distancing and preserve personal protective equipment (PPE). Therefore, it became clear early in our pandemic response that a new process was required to ensure the benefits of FCR were maintained given their paramount importance to safe and quality patient care. Objectives The objective of this study was to virtualize the in-person FCR process used by our pediatric inpatient medicine teams to improve safety and reduce PPE costs during the COVID-19 pandemic. Design/Methods We quickly identified available hardware (laptops, tablets) and video conferencing software, assembled a multidisciplinary project team and secured administrative and quality improvement support. Quality improvement methodology and participatory design were used to develop and refine our virtual family-centered rounds (vFCR) standard work, and on April 6, 2020 we launched our first vFCR. Over the next 3 months we engaged in a series of plan-do-study-act (PDSA) cycles to iteratively improve our process: nurse auditors attended vFCR daily then met with our project team to review data and observations, and real-time feedback was sought from patients and caregivers. Results Data collected on 1792 vFCR between April 6 and July 31, 2020 revealed 74% of nurses, physicians and trainees were satisfied or very satisfied with vFCR and 88% felt they had a good understanding of the patient care plan after vFCR. 79% of patients and caregivers were satisfied or very satisfied with vFCR and 88% of caregivers felt like a valued member of their child’s care team. We met our target of 10 minutes per patient in 74% of vFCR with an average transition time of <3 minutes between patients. Patients and caregivers felt vFCR were collaborative, more private and less intimidating than in-person FCR, and some even preferred the virtual approach. Conclusion During this pilot, we achieved a standardized vFCR workflow that is safe, feasible, efficient and confidential, with high levels of stakeholder satisfaction and support. vFCR was highly valued by families and yielded unanticipated benefits. Based on current usage, vFCR are saving ~$36,000 monthly in PPE. The importance of this work during the COVID-19 pandemic is clear, but also has benefits in non-pandemic times, including allowing caregivers to participate in FCR when they cannot be at the bedside, enhancing FCR confidentiality, and improving communication and care for isolated patients. Furthermore, the vFCR process is easily adaptable to other inpatient workflows such as consults and multi-disciplinary meetings. We believe this virtual care model is both highly relevant and transferable to a variety of health care settings across Canada and beyond.

Quality management system performance under force majeure risk (COVID-19 pandemic)

Aim. To assess the effectiveness of QMS implemented by Research Institute for Complex Issues of Cardiovascular Diseases (NII KPSSZ) in 2020 and determine the impact of force majeure event (COVID-19 pandemic) on the achievement of the goals and objectives of the organization.Methods. 11 QMS processes of the NII KPSSZ in 2020 were analyzed according to 98 performance criteria. The following general scientific methods were used for the assessment of QMS: analysis, synthesis, structural and systems analysis.Results. The overall effectiveness of the QMS in 2020 was 83.5%, for the individual processes it varies from 57% to 100%. Achievement of target indicators in accordance with the criteria reflects the effectiveness of risk management in QMS processes. 27 criteria were added (9 of which were reformulated) as a result of the development of the system and the analysis of work experience in unusual circumstances for year 2021. At the end of 2021, QMS will be analyzed according to 117 criteria for the processes effectiveness.Conclusion. The presented experience of quality management system functioning in 2020 highlights the significant roles of monitoring of the main processes and performance indicators analysis of scientific and medical organization in the ongoing COVID-19 pandemic. Such analysis is a necessary for decision-making because it allows the organization to fulfill the obligations, maintain conditions for increasing stakeholder satisfaction, monitor risks and assess opportunities associated with the environment and objectives of the organization, and ensure compliance with the standard requirements, regulations and legislation.

Yalın altı sigma: Kavramsal bir derleme

Being sustainable in today's business life has become the biggest goal of organizations. Ensuring customer satisfaction and stakeholder satisfaction in product and service delivery by providing competitive advantage has started to attract attention as an important priority not only for the private sector but also for public institutions. In this context, organizations can initiate the changes required by the age by applying post-modern management approaches and create proactive and reactive strategies by analyzing the environment. There are various methods used by organizations in this process. Six sigma concept is considered as a concept that advocates perfectionism and error-free in terms of providing customer satisfaction and increasing quality in many businesses, especially in production enterprises. On the other hand, lean production and management practices are also the art of embracing being free from elements that are not needed in the realization of activities. The Lean Six Sigma concept is a philosophy that focuses on business units and processes together. Lean Six Sigma advocates perfectionism and simplicity in all corporate processes by addressing the advantages of Six Sigma and Lean Management in a single managerial technique. In this research, it is aimed to examine Lean Six Sigma theoretically by considering Six Sigma and Lean Management techniques which are effective in the emergence of Lean Six Sigma concept. Referring to the studies on Six Sigma, Lean Management and Lean Six Sigma, it was concluded that the concept should be adopted and implemented in the private and public sector, not in a single process or unit, but in all institutions.

Junior doctor-led quality improvement project to improve safety and visibility of an interspecialty referral system

Interspecialty referrals for increasingly complex hospital inpatients are common and miscommunication often leads to delays in patient care. In a district general hospital, a web-based system generated an email referral, which lacked visibility and tracking/audit of the process, with no record generated automatically in paper inpatient notes or electronic patient records (EPR). We aimed to improve the visibility and safety of the interspecialty referral system.We canvassed stakeholders, informally and via an online satisfaction survey, collecting qualitative and quantitative data about attitudes to the existing system, generating ideas for change. We process mapped the system, identifying points of weakness. We adapted our EPR system, using a work-around solution, to develop a form that could be emailed from the EPR. This generated a permanent record within the EPR and an electronic record of the referral having been sent. We measured the visibility of referrals and responses within the EPR. We generated an online training ‘how-to’ video and reaudited stakeholder satisfaction.There was a significant increase in the proportion of junior doctors satisfied or very satisfied with the interspecialty referral system (27/31 postintervention; 87.1% vs 26/55 preintervention; 47%; p<0.0001) and more believed that the visibility was adequate or very adequate (24/31 postintervention; 77.4% vs 9/55 preintervention; 16.4%; p<0.0001). Visibility of referrals by project team members on the EPR increased from a baseline of 3.5% to 83.6% and the visibility of responses to these referrals on the EPR increased from 4.6% to 40.7%. Qualitative feedback was excellent, hospital executive approval was gained and our work-around system spread to non-team members.We developed a more visible and reliable interspecialty referral system, adapting existing EPR capabilities, which was popular with users and led to cultural change in interspecialty referral responders. A formal EPR redesign, informed by our project, is in development.