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Theory of Constraints (TOC), though a well-established process improvement methodology in manufacturing, is still a novel philosophy for healthcare and an exhaustive review of literature is needed to summarize the key findings of various researchers. Such a review can provide a direction to the researchers and academicians interested in exploring the application of TOC in the healthcare sector. This paper aims to review the existing literature of TOC tools and techniques applied to the healthcare environment, and to investigate motivating factors, benefits and key gaps for identifying directions for future research in the domain of healthcare.

In this paper, different electronic repositories were searched using multiple keywords. The current study identified 36 articles published between January 1999 to mid-2021 to conceptualize and summarize the research questions used in the study. Descriptive analysis along with pictorial representations have been used for better visualization of work.

This paper presents a thorough literature review of TOC in healthcare and identifies the evolution, current trends, tools used, nature of services chosen for application and research gaps and recommends future direction for research. A variety of motivating factors and benefits of TOC in healthcare are identified. Another key finding of this study is that almost all implementations listed in literature reported positive outcomes and substantial improvements in the performance of the healthcare unit chosen for study.

This paper provides valuable insight to researchers, practitioners and policymakers on the potential of TOC to improve quality of services, flow of patients, revenues, process efficiency and cost reduction in different health care settings. A number of findings and suggestions compiled in the paper from literature study can be used for diagnosing, learning and making substantial changes in healthcare. The methodologies used by different researchers were analysed and combined to propose a generic step by step procedure to apply TOC. This methodology will guide the practising managers about the appropriate tools of TOC for their specific need.

Good health is always the first desire of all men and women around the globe. The global aim of healthcare is to quickly cure more patients and ensure healthier population both today and in future. This article will work as a foundation for future applications of TOC in healthcare and guide upcoming applications in the booming healthcare sector. The paper will help the healthcare managers in serving a greater number of patients with limited available resources.

This paper provides original collaborative work compiled by the authors. Since no comprehensive systematic review of TOC in healthcare has been reported earlier, this study would be a valuable asset for researchers in this field. A model has been presented that links various benefits with one another and clarifies the need to focus on process improvement which naturally results in these benefits. Similarly, a model has been presented to guide the users in implementation of TOC in healthcare.

The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.

The methodology entails the integration of service design (SD) and action research (AR) methodologies, characterized by iterative phases that systematically alternate between action and reflective processes, fostering cycles of change and learning. Within this framework, stakeholders are engaged through semi-structured interviews, while the existing and envisioned processes are delineated and represented using BPMN 2.0. These methodological steps emphasize the development of an autonomous, patient-centric web application alongside the implementation of an adaptable and patient-oriented scheduling system. Also, business processes simulation is employed to measure key performance indicators of processes and test for potential improvements. This method is implemented in the context of the CP addressing transient loss of consciousness (TLOC), within a publicly funded hospital setting.

The methodology integrating SD and AR enables the detection of pivotal bottlenecks within diagnostic CPs and proposes optimal corrective measures to ensure uninterrupted patient care, all the while advancing the digitalization of diagnostic CP management. This study contributes to theoretical discussions by emphasizing the criticality of process optimization, the transformative potential of digitalization in healthcare and the paramount importance of user-centric design principles, and offers valuable insights into healthcare management implications.

The study’s relevance lies in its ability to enhance healthcare practices without necessitating disruptive and resource-intensive process overhauls. This pragmatic approach aligns with the imperative for healthcare organizations to improve their operations efficiently and cost-effectively, making the study’s findings relevant.

This paper aims to appraise the effectiveness of gender quotas in breaking the glass ceiling for women on boards (WoBs) in companies that are legally obliged to comply with quotas (listed companies and state-owned companies, LP) and in those that are not (unlisted companies and nonstate-owned companies, NLNP). Furthermore, it investigates the glass cliff phenomenon, according to which women are more likely to be appointed to apical positions in underperforming companies.

A balanced panel data of the top 116 Italian companies by total assets, which are present in both 2010 and 2017, is used for estimating ANOVA tests across sectors and fixed-effects panel regression models.

WoBs significantly increased in both the LP and the NLNP companies, and this increase was greater in the financial sector. Furthermore, the relationship between the percentage of WoBs and firm performance is not linear but depends on the financial corporate health. Specifically, the situation in which a woman ascends to a leadership position in challenging circumstances where the risk of failure is high (glass cliff phenomenon) is only present in companies with the lowest performance in the sample, in other words, when negative values of Roe and negative or zero values of Roa occur together.

These findings have relevant policy implications that encourage the adoption of gender quotas even in specific top positions, such as CEO or president, as this could lead to a “double spillover effect” both vertically, that is, in other job positions, and horizontally, toward other companies not targeted by quotas. Practical interventions to support women in glass cliff positions, on the other hand, relate to the extent of supervisor mentoring and support to prevent women from leaving director roles and strengthen their chances for career advancement.

The authors explore the ability of gender quotas to break through the glass ceiling in companies that are not legally obliged to do so, and to the best of the authors’ knowledge, for the first time, the glass cliff phenomenon in the Italian context.

The need to enhance student support is evident in higher education (HE) curricula. In addition to the complications created by the COVID-19 pandemic, the current strategies used in academia are criticised for their lack of appropriate student support in HE. The study focused on the themes under Section 4 of the National Student Survey (NSS): availability to contact tutors, receiving good advice and guidance and availability of good advice. The study aimed to provide recommendations for enhancing academic support by developing drivers that need implementation during course delivery.

A documental analysis and a qualitative survey were adopted for this study. A documental analysis of 334 mid-module reviews (MMRs) from levels three to six students in the built environment (BE) discipline. Critical themes identified from the MMRs were fed forward in developing a questionnaire for academics. A sample of 23 academics, including a Head of school, a Principal lecturer, Subject leads and Lecturers, participated in the questionnaire survey. Content analysis is adopted through questionnaire data to develop drivers to enhance academic support in BE. These drivers are then modelled by interpretive structural modelling (ISM) to identify their correlation to NSS Section 4 themes. A level partition analysis establishes how influential they are in enhancing academic support.

The study identified nine drivers, where two drivers were categorised as fundamental, two as significant, four as important, and one insignificant in enhancing academic support in HE. Module leaders’/tutors’ improving awareness and detailing how academic support is provided were identified as fundamental. Differentiating roles in giving advice and the importance of one-to-one meetings were identified as significant. A level partitioning diagram was developed from the nine drivers to illustrate how these drivers need to be implemented to promote the best practices in academic support in HE.

The identified drivers and their categories can be used to set prioritised guidelines for academics and other educational institutions to improve students’ overall satisfaction.

Novelty from the study will be the developed drivers and the level partitioning diagram to assist academics and academic institutions in successfully integrating academic support into HE curricula.

The European Union's Emissions Trading System (EU ETS), which is already one of the EU's most impactful instruments for reducing greenhouse gases (GHGs), will soon include the maritime transport industry. Although ports are this industry's most environmental-friendly component, there are still some barriers to including ports in the system. Therefore, the purpose of the study is to identify these barriers and to reveal the barriers' interrelationships.

The study was conducted by identifying barriers from a literature review before analyzing the barriers with the Fuzzy DEMATEL method. Finally, based on the Complex Adaptive System Approach, various solutions are proposed to overcome these barriers.

The identified barriers were grouped into cause-and-effect groups. Two barriers, namely long payback period and high investment costs, were evaluated as triggers of the model while the others were more sensitive to the model.

This study only includes the perceptions of green certificated ports in Türkiye. The results revealed an expectation that elimination of financial concerns will alleviate other barriers to including ports in the system. The study's findings can guide port managers on the integration of the managers' processes into the system.

This study provides novel findings regarding the relationships between barriers hindering ports from involvement in the EU ETS.

Value-based healthcare suggested using patient-reported information to complement the information available in the medical records and administrative healthcare data to provide insights into patients' perceptions of satisfaction, experience and self-reported outcomes. However, little attention has been devoted to questions about factors fostering the use of patient-reported information to create value at the system level.

Action research design is carried out to elicit possible triggers using the case of patient-reported experience and outcome data for breast cancer women along their clinical pathway in the clinical breast network of Tuscany (Italy).

The case shows that communication and engagement of multi-stakeholder representation are needed for making information actionable in a multi-level, multispecialty care pathway organized in a clinical network; moreover, political and managerial support from higher level governance is a stimulus for legitimizing the use for quality improvement. At the organizational level, an external facilitator disclosing and discussing real-world uses of collected data is a trigger to link measures to action. Also, clinical champion(s) and clear goals are key success factors. Nonetheless, resource munificent and dedicated information support tools together with education and learning routines are enabling factors.

Current literature focuses on key factors that impact performance information use often considering unidimensional performance and internal sources of information. The use of patient/user-reported information is not yet well-studied especially in supporting quality improvement in multi-stakeholder governance. The work appears relevant for the implications it carries, especially for policymakers and public sector managers when confronting the gap in patient-reported measures for quality improvement.

The advent of online live streaming platforms (OLSPs) and online health communities (OHCs) has expedited the integration of traditional medical services with Internet new media technology. Since the practice of physicians conducting live streaming is a relatively new phenomenon, the potential cross-platform effects of such physicians’ live streaming have not received adequate attention.

This study collected data from 616 physicians specializing in cardiology, obstetrics and gynecology and neurology between April and November 2022 on Live.Baidu.com and WeDoctor.com. It constructed a panel data set comprising a total of 4,928 observations over an 8-month period and validated the model using empirical analysis with the fixed-effects method.

We find evidence of cross-platform influence in online healthcare. Physicians’ live streaming behavior (whether live or not and the heat of their streams) on OLSPs positively impacts both their consultation and reputation on OHCs. Additionally, physicians’ ability positively moderates the relationships between live streaming heat and their performance (in terms of consultation volume and reputation) on OHCs. However, ability does not moderate the relationship between physicians’ live streaming status (live or not) and their performance (in terms of consultation and reputation) on OHCs. Furthermore, the attractive appearance of the physicians also significantly moderates the impact in a positive way.

This is one of the pioneering studies on physicians’ live streaming. The study offers vital guidance for physicians and patients utilizing dual platforms and holds significant reference value for platform operators (such as OLSPs and OHCs) aiming to optimize platform operations and for the government in policy formulation and industry regulation.

The primary purpose of this study is the development of Zimbabwe's rescue culture. The current framework for rescue operations was shaped by the historical development of laws pertaining to insolvency and liquidation. Socioeconomic pressures in Zimbabwe can be attributed to some of the main factors that led to the need for rescue legislation and restructuring, which in turn fueled the shift from a culture that supported credit to one that supported debtors. The aim of this study is to offer an overview of the key ideas and principles of the corporate rescue programs now implemented in Mauritius and to investigate the ways in which these ideas and principles impacted the newly enacted Zimbabwean Insolvency Act.

This study adopts a comparative legal approach using Zimbabwe and Mauritius as comparative case studies. The fact that both countries are former British colonies and their insolvency legal framework inspired by common law makes them appropriate to be compared. Legislation and case law are used to conduct the comparative study with the aim of Zimbabwe drawing lessons from the Mauritian legal framework on insolvency. Mauritius is a nearly ideal subject for a comparative case study because of its vibrant and fairly successful bankruptcy law framework, as well as its fictional corporate rescue culture. These might provide Zimbabwe with some motivation and guidance.

The legal framework on insolvency in Zimbabwe has been found to be too stringent and does not provide companies with any lifeline. There is arguably a tendency of forcing companies out of business rather than implementing a rescue culture. Selected aspects of the Mauritian legal framework on insolvency can be mapped onto the Zimbabwean system to implement a much-needed rescue culture given its challenging economic context.

This study contributes to comparative legal literature in the field of insolvency. It is among the very few research work that compares the legal structure on insolvency of Zimbabwe and Mauritius in a collaborative endeavor to enhance the insolvency law and its application in Zimbabwe.

This study aims to provide insights into gender diversity in Pakistani boardrooms, particularly for the dominant family business type, which is strongly guided by (non-financial) family-related objectives when making business decisions, such as the appointment of board members. Pakistani companies operate within the framework of weak legal institutions and a traditionally highly patriarchal environment. This study examines how corporate decisions regarding the appointment of female board members play out in this socio-political and cultural environment.

Board composition and board characteristics were examined using hand-collected data from 213 listed family firms and non-family firms on the Pakistan Stock Exchange from 2003 to 2017. Univariate analyses, probit regressions and robustness tests were performed.

Pakistani family firms have a significantly higher proportion of women on their boards than do non-family firms. They are also significantly more likely to appoint women to top positions, such as CEO or chairs.

Evidently, women are allowed to enter boards through family affiliations. Gender quotas appear an ineffective instrument for breaking through the “glass ceiling” in this socio-cultural environment. Thus, gender parity must entail the comprehensive promotion of women and the enforcement of legal reforms for structural and cultural change.

The analysis focuses on a Muslim-majority emerging Asian market that has been scarcely researched, thus offering new perspectives and insights into board composition and corporate governance that go beyond the well-studied Western countries.

The COVID-19 pandemic has caused severe challenges to ethnic minorities in the UK. While the experiences of migrants are both complex and varied depending on individuals' social class, race, cultural proximity to the host country and acculturation levels, more in-depth studies are necessary to fully understand how COVID-19 affects specific migrant groups and their health. Taiwanese migrants were selected because they are an understudied group. Also, there were widespread differences in pandemic management between the UK and Taiwan, making this group an ideal case for understanding how their acculturation journey can be disrupted by a crisis.

Qualitative data were collected at two different time points, at the start of the UK pandemic (March/April 2020) and six months on (October/November 2020), to explore migrant coping experiences over time. Theoretically, the authors apply acculturation theory through the lens of coping, while discussing health-consumption practices, as empirical evidence.

Before the outbreak of the pandemic, participants worked hard to achieve high levels of integration in the UK. The pandemic changed this; participants faced unexpected changes in the UK’s sociocultural structures. They were forced to exercise the layered and complex “coping with coping” in a hostile host environment that signalled their new marginalised status. They faced impossible choices, from catching a life-threatening disease to being seen as overly cautious. Such experience, over time, challenged their integration to the host country, resulting in a loss of faith in the UK’s health system, consequently increasing separation from the host culture and society.

It is important to note that the Taiwanese sample recruited through Facebook community groups is biased and has a high level of homogeneity. These participants were well-integrated, middle-class migrants who were highly educated, relatively resourceful and active on social media. More studies are needed to fully understand the impact on well-being and acculturation of migrants from different cultural, contextual and social backgrounds. This being the case, the authors can speculate that migrants with less resource are likely to have found the pandemic experience even more challenging. More studies are needed to fully understand migrant experience from different backgrounds.

Public health policymakers are advised to dedicate more resources to understand migrants' experiences in the host country. In particular, this paper has shown how separation, especially if embraced temporarily, is not necessarily a negative outcome to be corrected with specific policies. It can be strategically adopted by migrants as a way of defending their health and well-being from an increasingly hostile environment. Migrants' home country experience provides vicarious learning opportunities to acquire good practices. Their voices should be encouraged rather than in favour of a surprising orthodox and rather singular approach in the discussion of public health management.

The paper has clear public health policy implications. Firstly, public health policymakers are advised to dedicate more resources to understand migrants' experiences in the host country. Acknowledging migrants' voice is a critical first step to contribute to the development of a fair and inclusive society. Secondly, to retain skilful migrants and avoid a future brain-drain, policymakers are advised to advance existing infrastructure to provide more incentives to support and retain migrant talents in the post-pandemic recovery phase.

This paper reveals how a group of previously well-integrated migrants had to exercise “coping with coping” during the COVID crisis. This experience, over time, challenged their integration to the host country, resulting in a loss of faith in the UK’s health system, consequently increasing separation from the host culture and society. It contributes to the understanding of acculturation by showing how a such crisis can significantly disrupt migrants' acculturation journey, challenging them to re-acculturate and reconsider their identity stance. It shows how separation was indeed a good option for migrants for protecting their well-being from a newly hostile host environment.