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The purpose of this paper is to conduct an empirical study derived from the previous literature from the perspective of benefits, tools and techniques, continuous improvement (CI) and quality improvement (QI) methodologies and critical failure factors (CFFs) of Lean and Six Sigma (SS) in the national health service (NHS).

A literature review was carried out to identify previous findings, empirical data and critical variables concerning Lean and SS in healthcare for over ten years. Second, primary research in quantitative surveys and qualitative interviews was carried out with 110 participants who have experience using Lean and SS in the NHS.

Lean and SS have evolved into common practices within the NHS and now have an established list of tools and techniques frequently employed by staff. Lean and SS are considered robust CI methodologies capable of effectively delivering extensive benefits across many different categories. The NHS must overcome a sizable amount of highly important CFFs and divided organizational culture.

This paper has developed the most extensive empirical study ever produced on Lean and SS in the NHS and has expanded on previous works to create new and updated research. The findings produced in this paper will assist NHS medical directors and practitioners in obtaining up-to-date insight into Lean and SS status in the NHS. The paper will also guide the NHS to critically evaluate their current CI strategy to ensure long-term sustainability and deliver improved levels of service to patients.

Looks at the growing importance of quality management in local government. Identifies the current thinking behind total quality and the need to apply established theory in the public domain, and explores the approaches and methodologies which are currently available to do this. Develops a framework for total quality from the work of a number of quality gurus. This framework can be used to examine the key requirements of total quality implementation, and hence expanded to take account of the special purpose of, and constraining conditions which apply to, local authorities.

Looks at the growing importance of quality management in local government. Explores the work undertaken in three London Borough Councils and one District Council in Essex which are attempting to apply management principles to all areas of their activity. Compares each council using a framework for quality management. Describes the differences in their approaches to implementing quality, exploring why those differences may have come about. Identifies a number of important questions which should be considered when planning any local government quality initiative.

The paper aims at providing empirically‐based insights into product development when environmental performance requirements are addressed. The purpose is to investigate characteristics of product development projects when environmental performance requirements are considered.

The research was carried out as in‐depth case studies of two commercial product development projects. Data was primarily collected via open‐ended semi‐structured interviews. Other sources of data include written project material, such as minutes from meetings, project and product specifications, company‐internal education material, etc. A few project meetings were also attended.

The paper indicates that the characteristics of product development projects differ when environmental performance requirements are considered. On the basis of the identified differences a two‐dimensional model is suggested. It contains the dimensions “level of ecodesign experience” and “environmental complexity”. The model outlines a tentative contingency framework that can be used for positioning different organisations concerning their level of experience in ecodesign and the challenges they face concerning complexity in the interrelationships between the products and the environment.

The findings presented in the paper provide some insights into the characteristics of projects carried out in organisations in which the “level of ecodesign experience” and “environmental complexity” differ. Aspects related to the two dimensions represented in the model are discussed in the paper. This should support companies to be better prepared for managing the challenges associated with the incorporation of environmental performance requirements into product development projects.

Although different issues have been addressed in earlier ecodesign research, one problem is that ecodesign research often addresses the environmental impacts exclusively, whereas other aspects of product development are omitted or only briefly discussed. Taking the starting point in a number of elements that have been outlined in the literature as representing vital areas of concern in product development, this paper contributes to the understanding of how development organisations consider environmental performance requirements in the product development projects.

This paper aims to discuss the possibility of joining cybernetics and architecture as a continuous and open process, bridging design, construction and use, in that which is called cyberarchitecture.

It develops the hypothesis that cyberarchitecture can benefit from taking the virtual into account in the design process, so that the architect is no longer the author of a finished architectural product, but of a set of instruments with which users can design, build and use their own environments simultaneously.

A set of design principles is systematised and examined in three practical realms of design: urban, building, and relational, showing cyberarchitecture's embryonic feasibility.

Cyberarchitecture implies that architects are no longer authors of finished products and users, becoming designers of their own spaces.

Cyberarchitecture avoids the usual cybernetics approach based on control‐system, indicating a less predictive and, ultimately, anarchic path for architects and users. It focuses on architecture's intrinsic value as an event, indicating the possibility of a process‐based system, which only exists (or is organised) in present‐time, when users and instruments (or structures) interact.

The purpose of this chapter is to summarize and integrate a body of psychological literature regarding an individual difference related to the experience of anxiety that largely, and somewhat surprisingly, has been overlooked by organizational scientists. This variable, most often called social anxiety or social phobia, reflects a strong fear that one is in danger of behaving inappropriately, inadequately, or ineptly, with impending disastrous consequences such as rejection, humiliation, or ouster from a group (Trower & Gilbert, 1990). In providing a summary of the construct and ongoing investigations, the chapter offers ideas for future research into how this important variable may influence behaviors at work.

In the last few years, signs of material excess by organizational and political leaders have often evoked public outcry. The paper aims to argue that there is insight to be gleaned from drawing together strands from the leadership literature with the literatures on moral economy and conspicuous consumption. The premise is that views of leader conspicuous consumption are shaped by their moral economy, the interplay between moral attitudes and economic activities. The paper seeks to juxtapose tales of Cleopatra and Antony's display of wealth with current media accounts to contribute to the leadership literature on ethics, specifically its intersection with power and narrative representation.

The paper adopts an analytic approach, with an international orientation and an interdisciplinary perspective. It acknowledges the role of narrative representation in shaping leadership and the psychological ambivalence with which societies approach their leaders' practices, focus here on desire-disdain and discipline-decadence. Cleopatra and Antony's conspicuous consumption generated a legacy of condemnation for millennia. Drawing from the retellings of their story, four moralizing representations – by Plutarch, Shakespeare, Sarah Fielding and Hollywood – are analyzed and juxtaposed with current media accounts. Altogether, the paper combines the interest in leadership across history with moralizing perspectives on the display of wealth by leaders.

The intersection of the literatures on leadership, moral economy and conspicuous consumption draws together several dynamics of relevance to leadership. First, evaluations of the display of wealth on the part of a leader are contextual: they change across time and place. Second, interpretations of conspicuous consumption involve aesthetic judgment and so sit at the nexus of morality and taste. Third, following tragedies, tales of leader conspicuous consumption offer critics another knife to dig into the fallen tragic hero. Fourth, views of conspicuous consumption are gendered. Last, conspicuous consumption by leaders attracts condemnation through support for social responsibility and sustainability.

The paper establishes a novel articulation between the literatures on leadership, moral economy and conspicuous consumption.

The study aims to assess medical engagement levels at two teaching hospitals and a 500 bed private hospital in two states operated by the same health care provider and to describe individual and organisational factors that influence and change medical engagement.

A survey was emailed to all junior and senior medical staff, seeking responses to 30 pre-determined items. The survey used a valid and reliable instrument which provided an overall index of medical engagement. Qualitative data were also collected by including an open ended question.

Doctors (n = 810) working at all sites are in the top 20-40 percentile when compared to Australia and the United Kingdom. Two sites in one state were in the highest relative engagement band with the other being in the high relative range when compared to the (UK) and the medium relative band when compared to sites in Australia. Senior doctors working at all three were less engaged on feeling valued and empowered, when compared to having purpose and direction or working in a collaborative culture. This appears to be related to work satisfaction and whether they feel encouraged to develop their skills and progress their careers. Junior doctors at 1 site are much less engaged than colleagues working at another. Since their formal training pathways are identical the informal training experience appears to be an engagement factor.

Despite medical engagement being recognised as crucial, little is known about individual and organisational factors that support doctors to be engaged, particularly for juniors and in the private sector.