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The goal was to improve the quality of the hospitalization process and the management of patients, allowing the reduction of costs and the minimization of the preoperative Length of Hospital Stay (LOS).

The methodology used to improve the quality of the hospitalization process and patient management was Lean Thinking. Therefore, the Lean tools (Value stream map and Ishikawa diagram) were used to identify waste and inefficiencies, improving the process with the implementation of corrective actions. The data was collected through personal observations, patient interviews, brainstorming and from printed medical records of 151 patients undergoing oral cancer surgery in the period from 2006 to 2018.

The authors identified, through Value Stream Map, waste and inefficiencies during preoperative activities, consequently influencing preoperative LOS, considered the best performance indicator. The main causes were identified through the Ishikawa diagram, allowing reflection on possible solutions. The main corrective action was the introduction of the pre-hospitalization service. A comparative statistical analysis showed the significance of the solutions implemented. The average preoperative LOS decreased from 4.90 to 3.80 days (−22.40%) with a p-value of 0.001.

The methodology allowed to highlight the improvement of the patient hospitalization process with the introduction of the pre-hospitalization service. Therefore, by adopting the culture of continuous improvement, the flow of hospitalization was redrawn. The benefits of the solutions implemented are addressed to the patient in terms of lower LOS and greater service satisfaction and to the hospital for lower patient management costs and improved process quality. This article will be useful for those who need examples on how to apply Lean tools in healthcare.

Head and neck cancers are multi-factorial diseases that can affect many sides of people's life and are due to a lot of risk factors. According to their characteristics, the treatment can be surgical, use of radiation or chemotherapy. The use of a surgical treatment can lead to surgical infections that are a main theme in medicine. At the University hospital of Naples “Federico II”, two antibiotics were employed to tackle the issue of the infections and they are compared in this paper to find which one implies the lowest length of hospital stay (LOS) and the reduction of infections.

The Six Sigma methodology and its problem-solving strategy DMAIC (define, measure, analyse, improve, control), already employed in the healthcare sector, were used as a tool of a health technology assessment between two drugs. In this paper the DMAIC roadmap is used to compare the Ceftriaxone (administered to a group of 48 patients) and the association of Cefazolin plus Clindamycin (administered to a group of 45 patients).

The results show that the LOS of patients treated with Ceftriaxone is lower than those who were treated with the association of Cefazolin plus Clindamycin, the difference is about 41%. Moreover, a lower number of complications and infections was found in patients who received Ceftriaxone. Finally, a greater number of antibiotic shifts was needed by patients treated with Cefazolin plus Clindamycin.

While the paper enhances clearly the advantages for patients' outcomes regarding the LOS and the number of complications, it did not analyse the costs of the two antibiotics.

Employing the Ceftriaxone would allow the Department of Maxillofacial Surgery to obtain lower LOS and a limited number of complications/infections for recovered patients, consequently reducing the hospitalization costs.

There is a double value in this paper: first of all, the comparison between the two antibiotics gives an answer to one of the main issues in medicine that is the reduction of hospital-acquired infections; secondly, the Six Sigma through its DMAIC cycle can be employed also to compare two biomedical technologies as a tool of health technology assessment studies.

In the current context of change, leadership is significant in developing employees' commitment to change. In this work, the authors analysed the relationship between inclusive leadership and commitment to change and the mediating effect of job satisfaction between inclusive leadership and commitment to change.

Through a questionnaire, 256 employees from Brazil and Spain were interviewed. The hypotheses were tested through structural equations.

The results indicated that inclusive leadership is related to individuals' commitment to change and that job satisfaction mediates the relationship between leadership and commitment to change.

This research contributes to the literature on organisational change behaviour and the relationship between two critical contents – leadership and commitment to change – and points out the role of job satisfaction in this relationship. In addition, this work incorporates the variable country culture into the analysis model; however, it is not found to be statistically significant.

在目前改革的環境裡,若要培育僱員負起改革的承諾,領導者的素質和能力是甚為重要的。本研究擬探討並分析包容性領導與改革承諾之間的關係,以及工作滿足感在包容性領導與改革承諾之間的中介效應。

研究人員透過問卷、訪問了256名來自巴西和西班牙的僱員。各假設均以結構方程式來進行測試。

研究結果顯示、包容性領導與個別員工的改革承諾是有關聯的; 另外,工作滿足感是會於領導與員工的改革承諾之間起中介效應。

本研究在關於組織變革行為與兩個關鍵內容 (分別為領導和改革承諾) 之間的關係的學術文獻上作出了貢獻。研究亦指出、工作滿足感在領導與改革承諾之間所扮演的角色。再者,本研究把國家的文化這個變數納入研究的分析模型內; 唯研究結果顯示、國家的文化在統計學上不成立。

Banks in emerging markets such as Brazil provide a wide range of services to companies to facilitate the export process. The objective of the present study was to analyze, from the perspective of Brazilian export companies, the relationships between banking intellectual capital (human and organizational), banking agility, banking technologies and company size in banking service provision.

A sample of 318 Brazilian export companies was surveyed with questionnaires. The research model was tested using structural equation modeling, namely the partial least squares (PLS-SEM) technique and SmartPLS.

Banking intellectual capital affects banking service provision, banking agility mediates the relationship between intellectual capitals and banking service provision and technology does not moderate the relationship between agility and banking service provision. The size of the company does not moderate the relationship between intellectual capital and banking service provision.

This work indicates that intellectual capital and the banking agility strategy are critical in the provision of banking service provision for exports.

This work illustrates the effect of banks' intangible resources on the provision of banking services from the perspective of Brazilian export companies.

This paper discusses how mystery was imprinted into the Jesuit Spiritual Exercises, supporting their diffusion across space and time. It shows that the book of the Spiritual Exercises is a practice in itself and fosters a practice or set of practices. The book is more than an object: it is an action, unleashed not by the specification of what actions it dictates but by the mystery the “book-as-practice” carries. The paper contributes to the literature on practice-driven institutionalism, namely by showing how mystery furthers our understanding of the mutual constitution of practices and institutions. The Spiritual Exercises have been practiced for more than four centuries, even though their meaning is not stable and they are never fully understood. Therefore, our paper asks: how do the Jesuits understand what they have to do if the book does not prescribe everything? The authors argue that it is indeed this mystery that distinguishes religious practices, explaining their endurance across time and space and, henceforth, their institutionalization. The authors show that the Spiritual Exercises are to be practiced and it is this practicing that allows them to diffuse and institutionalize a new understanding of how the individual relates to God. “God’s will” is searched through the practicing, without ever being determined by the practice. It is by practicing the book that the mystery of “God’s will” reveals itself. Moreover, “God’s will” is never known or knowable. Instead, it is embodied and felt while practicing the book of the Exercises. Emotions thus reconcile, through mystery, the book and the practicing of it. Our paper contributes to practice-driven institutionalism by showing how mystery can drive institutionalization processes.

The purpose of this study is to analyse the brand communication on social media (SM) made by two- and three-starred restaurants and the customer reaction in terms of engagement effects during a crisis. The research highlights the connections between brand communication and engagement dynamics on Instagram by looking for differences in the strategies of two and three-starred restaurants and by highlighting the changes in the background engagement drivers.

Using data collected from 5,666 Instagram posts by 34 Italian Michelin-starred restaurants, the authors analysed the crisis-driven changes in online communication and customer engagement comparing three phases of the COVID-19 pandemic by applying a linear regression model with fixed effects.

Michelin-starred restaurants changed their strategies of brand communication to overcome the effects of the crisis. The findings highlight the importance of SM as a tool to stay in touch with consumers and the pivotal role of customers in engagement, especially during a pandemic.

To the best of the authors’ knowledge, this is among the first studies to investigate the changes in brand communication and the effects on customer engagement during a pandemic, with a focus on Instagram. It contributes to understanding the role of platform and the main drivers of engagement on Instagram, as well as suggesting how managers can improve brand value using SM.