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This paper aims to characterize a sample of Lean Six Sigma (LSS) projects in healthcare settings and discuss some specificities of operational excellence (OPEX) initiatives in hospitals and healthcare organizations in the USA.

A content analysis involving a sample of 23 documents shared by US hospitals was performed in order to achieve the research objectives. Such analysis was based on a conceptual framework developed from the literature review. It was also applied to a quantitative approach, including descriptive statistics, hypothesis testing and correspondence analysis that supported the research.

Most LSSH projects were focused on business transformation and strategic improvements. Simple techniques and tools were predominant such as descriptive statistics, process mapping, 5S and spaghetti charts, usually implemented by Green Belts and Black Belts through the define, measure, analyze, improve and control (DMAIC) method. In addition to the expressive findings reported, these projects' results have been aligned with lead time and operational cost reduction, quality improvement and capacity increase.

The study adds knowledge to the OPEX literature by analyzing the Lean Six Sigma healthcare (LSSH) in hospitals and healthcare institutions in the USA. It also demonstrates that different approaches, such as the kaizen event and DMAIC project show different results according to some techniques and tools applied in the hospital environment.

The empirical evidence presented in this study provides scenery of the LSS practices in the healthcare settings, highlighting the implementation areas, outcomes, tools and techniques mostly used in the North American healthcare institutions.

Research has examined how new ventures strengthen local economic outcomes; however, limited research examines health-oriented ventures and their impact on social outcomes, including health outcomes. Increased VC investment in healthcare service start-ups signals more activity toward this end, and the need for further academic inquiry. We examine the relationship between these start-ups and county-level health outcomes, health factors, and hospital utilization.

Data on start-ups funded via institutional venture capital from PitchBook were merged with US county-level outcomes from the County Health Rankings and Area Health Resources Files for 2010 to 2019. We investigated how the number of VC-funded healthcare service start-ups, as well as a subset defined as innovative, were associated with county-level health measures. We used panel models with two-way fixed effects and Propensity Score Matched (PSM), controlling for demographics and socioeconomic factors.

Each additional VC-funded healthcare service start-up was related to a significant 0.01 percentage point decrease in diabetes prevalence (p < 0.01), a decrease of 1.54 HIV cases per 100,000 population (p < 0.1), a 0.02 percentage point decrease in obesity rates (p < 0.01), and a 0.03 percentage point decrease in binge drinking (p < 0.01). VC-funded healthcare service start-ups were not related to hospital utilization.

This work expands our understanding of how industry-specific start-ups, in this case healthcare start-ups, relate to positive social outcomes. The results underscore the importance of evidence-based evaluation, the need for expanded outcome measures for VC investment, and the possibilities for integration of healthcare services and entrepreneurship ecosystems.

The US prison population has recently reached an all-time high, with women representing the fastest growing subpopulation. Correctional health-care system in the USA remains fragmented and nonuniform in practice, particularly in women’s health care, with poor transitions between incarceration and release. This study aims to examine the qualitative health-care experiences of women while incarcerated and their transition into the community health-care setting. Additionally, this study also examined the experiences of a subset of women who were pregnant while incarcerated.

After obtaining institutional review board approval, adult, English-speaking women with a history of incarceration within the past 10 years were interviewed using a semi-structured interview tool. Interview transcripts were analyzed using inductive content analysis.

The authors completed 21 full interviews and identified six themes that were both the most significant and most novel: “feeling stigmatized and insignificant,” “care as punishment,” “delay in care,” “exceptions to the rule,” “fragmentation of care” and “obstetric trauma and resilience.”

Women face numerous barriers and hardships when accessing basic and reproductive health-care services while incarcerated. This hardship is particularly challenging for women with substance use disorders. The authors were able to describe for the first time, partially through their own words, novel challenges described by women interacting with incarceration health care. Community providers should understand these barriers and challenges so as to effectively reengage women in care upon release and improve the health-care status of this historically marginalized group.

Healthcare supply chains (HCSCs) face severe challenges when compared to regular chains. Besides avoiding bankruptcy, they must accomplish their goal which is to save lives. Since 2019 the COVID-19 pandemic evidenced that a HCSC disruption generates disruptions to other SCs. Therefore, the objective of this paper is threefold: conduct a systematic literature review to build a HCSC operational excellence (HSCOE) definition; build a conceptual framework by mapping the antecedents of HSCOE and formulate hypotheses; test the hypotheses using a fuzzy-Set Qualitative Comparative Analysis (fsQCA) combined with partial least squares structural equation modeling (PLS-SEM) techniques to obtain empirical validation.

Given this context, this paper conducted a systematic literature review to build a HSCOE conceptual framework and used a fsQCA combined with PLS-SEM techniques to obtain empirical validation.

The paper revealed a relationship between important variables to achieve HSCOE, such as Supply chain 4.0, SC risk management, SC integration, SC resilience (antecedents) and HSCOE (consequent).

The literature contributions of this paper are as follows: validating a new scale for each of the constructs; finding evidence of the causal relationships between the latent variables; measuring how the constructs influence the HSCOE; in addition, the results address important literature gaps identified by researchers and serve as a guide to organizations that need to implement these practices. Furthermore, this study recommends that HCSC managers consider the implementation of robust initiatives concerning the latent variables presented in this work.