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Many healthcare organizations are looking for methods, such as Lean, to reduce their costs and increase the productivity of their professionals. The Lean method looks at every step in every process to assess if this step adds value for the customer or not. The aim of this study was to explore the value adding and non-value adding process steps in stroke patient admission in an integrated care stroke service in the Netherlands.

This study focused on discharge of stroke patients from hospital acute treatment, and they were admitted for rehabilitation. According to the Grounded Theory, value stream mapping, organized interviews and expert meetings and coded was used. A configuration analysis was used to distinguish aggregates and configurations.

The most reported issues concerned in the paper are as follows: (1) insufficient internal logistics in the hospital, (2) miscommunication about medical readiness for discharge of the patient, (3) missing or delayed medical patient information, (4) overlapping discharge interviews, (5) unsafe transfer of sensitive information and (6) waiting lists and queuing up in rehabilitation facility.

At least six main areas of waste were identified in this stroke service, and they form the target for waste reducing activities. The results give insight in possible wastes in healthcare organizations and are therefore beneficial for other healthcare organizations which are planning to reduce wastes.

The study aims to map the links between Industry 4.0 (I-4.0) technologies and circular economy (CE) for sustainable operations and their role to achieving the selected number of sustainable development goals (SDGs).

The study adopts a systematic literature review method to identify 76 primary studies that were published between January 2010 and December 2020. The authors synthesized the existing literature using Scopus database to investigate I-4.0 technologies and CE to select SDGs.

The findings of the study bridge the gap in the literature at the intersection between I-4.0 and sustainable operations in line with the regenerate, share, optimize, loop, virtualize and exchange (ReSOLVE) framework leading to CE practices. Further, the study also depicts the CE practices leading to the select SDGs (“SDG 6: Clean Water and Sanitation,” “SDG 7: Affordable and Clean Energy,” “SDG 9: Industry, Innovation and Infrastructure,” “SDG 12: Responsible Consumption and Production” and “SDG 13: Climate Action”). The study proposes a conceptual framework based on the linkages above, which can help organizations to realign their management practices, thereby achieving specific SDGs.

The originality of the study is substantiated by a unique I-4.0-sustainable operations-CE-SDGs (ISOCES) framework that integrates I-4.0 and CE for sustainable development. The framework is unique, as it is based on an in-depth and systematic review of the literature that maps the links between I-4.0, CE and sustainability.

The study aims to propose a circular economy-based reverse logistics (CERL) that emphasises the mediation effect of reverse logistics (RL) on sustainable resource commitment and financial performance.

The structural equation modelling (SEM) approach has been applied to analyse the data acquired through the survey method that included 113 vendors of automotive supplies of the 1st and 2nd levels.

The results confirm that CERL acts as an essential intervening entity between resources and financial performance. The findings of the study have provided research and development (R&D) opportunities for the industries to find alternative revenue streams and generate profit from resource investment whilst upholding environmental standards through reverse logistic practices.

Reverse logistic practices are the key components of a circular business model and a sustainable supply chain. The manufacturing companies need to explore critical enablers that can contribute to business productivity and financial growth.

The study has validated a CERL model that portrays the circular economy's resilient relationship with RL practices.

The study aims to define a research agenda for creating resource-efficient supply chains (RESCs) by identifying and analysing their key characteristics as well as future research opportunities.

We follow a systematic review method to analyse the literature and to understand RESC, taking a substantive theory approach. Our approach is grounded in a specific domain, the agri-food sector, because it is an intensive user of an extensive range of resources.

The review shows that works of literature has looked at the use of resources primarily from the environmental impact perspective. There is a need to explore whether or not and how logistics/supply chain decisions will affect the overall configuration of future food supply chains in an era of resource scarcity and depletion and what the trade-offs will be.

The paper proposes an agenda for future research in the area of RESC. The framework proposed along with the key characteristics identified for RESC can be applied to other sectors.

Our research should facilitate further understanding of the implications and trade-offs of supply chain decisions taken on the use of resources by supply chain managers.

The paper explores the interaction between supply chains and natural resources and defines the key characteristics of RESC.

The purpose of this study is to investigate the perceived effects between soft management practices, employee behaviours and the implementation of digital technologies in manufacturing plants, as well as how these relate to the emergence of digital waste.

This paper uses case-based research. Data was collected in two large manufacturing companies based in Norway and Sweden through semi-structured interviews with two management representatives and four shop-floor employees. The data was used to evaluate 29 variables describing lean- and total quality management (TQM)-associated employee behaviours and soft management practices, in light of digital transformation.

The results suggest that several variables were positively influenced by the digital transformation process. These were top management leadership, middle management involvement, employee education, corporate social responsibility focus, innovation, knowledge sharing, work-family balance, psychological capital, job satisfaction and career commitment. Training employees, creativity, discretionary effort, turnover intention and proactivity appear to be negatively influenced by digital transformation The findings also indicate that several soft management practices and employee behaviours were not only influenced by manufacturing digitalization but also themselves influenced the process. The potential for digital waste creation was also detected in several variables, including reward and recognition and training employees.

Managers, practitioners and academics may learn about the importance of certain managerial practices and employees’ behavioural needs during the digital transformation process. The findings may help in prioritizing TQM and soft lean management practices and certain employee behaviours during the digital transformation and in creating awareness of digital waste.

This study builds on several existing studies discussing the impact of digital transformation on soft management practices and employee behaviours. It provides insights from a lean and TQM angle and offers a means of prioritizing certain practices and behaviours during a digital transformation. This study also highlights the significance of digital waste.

This paper aims to reveal the philanthropy landscape processes for dealing with disasters and examine the influence of lean thinking in managing philanthropy for disasters. It sought to leverage continuous improvement and maximise disaster response and humanitarian logistics efficiency.

A sequential quantitative, qualitative research methods strategy was utilised involving data collection with literary analysis and two sets of online surveys with 212 NGO staff members in Malawi, Mozambique, South Africa and Zimbabwe. In addition, in-depth key informant interviews were conducted with 23 staff members at various management levels from these countries.

The study found that lean thinking had a positive, statistically valid influence at a 95% confidence level. Community incorporation, government support and collaboration with other philanthropic organisations were critical success factors. When lean thinking tools were applied (any tools), philanthropic organisations experienced waste reduction and value addition, where waste reduction accounted for 67% variation, and value-addition accounted for 58%, respectively. These were the same benefits experienced in other industries, thus, justifying lean thinking's applicability in the non-profit sector. Lean was most helpful about the communication and duplication of efforts challenges humanitarian or philanthropic organisations face when responding to a disaster.

The study equips leaders and philanthropic organisations with suggestions to manage and respond to disasters in a lean and effective manner. The study helps philanthropy leaders rethink their funding and response models to pursue lean policies catering to humanitarian organisations and the communities they serve.

The study closes significant gaps in the literature and practice by adopting a multi-sectoral lens that borrows from business and manufacturing tools into a non-profit context. It enables documentation of processes and logistical management by philanthropy organisations for continuous improvement and elimination of waste to ensure efficiency in the philanthropic role of alleviating the impact of disasters. The study also affirms the need for philanthropic organisations to incorporate community feedback, use lean tools to collaborate with other responding organisations and work closely with the local authorities to fulfil the government's supportive role: the primary source and executor in disaster response.

This paper aims to examine lean thinking in medical commodities supply chains by considering its applications and success factors. It determines the drivers and wastes of medical commodity supply chain, and the existing lean tools and practices together with their application in the supply chain processes. The paper also examined the challenges and success factors for effective lean application in the medical commodities supply chains.

The study used qualitative approaches, in-depth interviews and focus group discussions with key informants to form the basis for data collection. Through thematic analysis, the collected data were analyzed by developing themes reflecting the objectives of the study.

The main drivers for waste associated with the supply chain were demand management, supplier development, institutional framework and governance. The wastes were observed at the level of inventory, operation costs, transaction costs, delays in terms of service, commodity delivery time and quality. Digitalization, information technology and standardization were the tools for medical supply chain. Poor infrastructure, unreliable internet supply, environmental uncertainty and poor management support were challenges to realizing an effective supply chain.

Although the qualitative approach used in the study provides detailed information, a quantitative study covers a larger sample for generalization.

Capacity building and professionalism should be given a priority because the philosophy of lean focuses on waste removal and continuous improvement, which highly depends on the quality of human resource (Brito et al., 2020). Limited human resource capabilities in supply chain management will, therefore, result into poor operational efficiency, which are wasted. Moreover, systems interoperability is key waste minimization and, therefore, demands interventions.

The government under the Ministry of Health and other key sector ministries such as local and regional governments should better understand the role of the waste drivers and adopt system-wide reforms to support improvements to remove waste in the medical supply chain. For example, the current institutional framework creates an administrative block and hence leads to wastes. This bureaucratic procedure should be removed to minimize wastes along the chain.

This study is among the first studies to determine applicability and implementation of lean in a resource-constrained context. The paper identifies contextual factors for lean implementation. This paper focused on a holistic view of the entire supply chains to enhance a well-functioning supply chain in delivering health commodities.

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.

This study aimed to bridge the gap between the financial measurement of process improvement ideas and Lean Six Sigma measurements. It was required to increase employee engagement in process improvement initiatives.

Through both a practical and theoretical application of the Design for Lean Six Sigma methodology, the researcher was able to design a process and a benefit measuring methodology that was acceptable by finance and aligns with the benefits expected from the elimination of the Lean wastes.

The project found that benefit measurement methodology is not understood by most employees, which leads to a lack of engagement in working on improvements. The result of the study was a model for employees to identify and quantify these benefits. This has resulted in a model for cost-benefit analysis aligning financial costs with non-value add waste costs and cost of poor-quality costs resulting in increased process improvement ideas and activity.

While this study was limited to one company, applying this methodology could benefit any company experiencing the same difficulties.

This is one of the first studies to try and cost the benefits of LSS projects both from an organisational and generic viewpoint.

This study aims to improve a construction company's overall project delivery by utilising lean six sigma (LSS) methods combined with building information modelling (BIM) to design, modularise and manufacture various building elements in a controlled factory environment off-site.

A case study in a construction company utilised lean six sigma (LSS) methodology and BIM to identify non-value add waste in the construction process and improve sustainability.

An Irish-based construction company manufacturing modular pipe racks for the pharmaceutical industry utilised LSS to optimise and standardise their off-site manufacturing (OSM) partners process and leverage BIM to design skids which could be manufactured offsite and transported easily with minimal on-site installation and rework required. Productivity was improved, waste was reduced, less energy was consumed, defects were reduced and the project schedule for completion was reduced.

The case study was carried out on one construction company and one construction product type. Further case studies would ensure more generalisability. However, the implementation was tested on a modular construction company, and the methods used indicate that the generic framework could be applied and customized to any offsite company.

This is one of the few studies on implementing offsite manufacturing (OSM) utilising LSS and BIM in an Irish construction company. The detailed quantitative benefits and cost savings calculations presented as well as the use of the LSM methods and BIM in designing an OSM process can be leveraged by other construction organisations to understand the benefits of OSM. This study can help demonstrate how LSS and BIM can aid the construction industry to be more environmentally friendly.