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The future increase of chronic diseases in the world requires new challenges in the health domain to improve patients' care from the point of view of the organizational processes, clinical pathways and technological solutions of digital health. For this reason, the present paper aims to focus on the study and application of well-known clinical practices and efficient organizational approaches through an innovative model (TALIsMAn) to support new care process redesign and digitalization for chronic patients.

In addition to specific clinical models employed to manage chronic conditions such as the Population Health Management and Chronic Care Model, we introduce a Business Process Management methodology implementation supported by a set of e-health technologies, in order to manage Care Pathways (CPs) digitalization and procedures improvement.

This study shows that telemedicine services with advanced devices and technologies are not enough to provide significant changes in the healthcare sector if other key aspects such as health processes, organizational systems, interactions between actors and responsibilities are not considered and improved. Therefore, new clinical models and organizational approaches are necessary together with a deep technological change, otherwise, theoretical benefits given by telemedicine services, which often employ advanced Information and Communication Technology (ICT) systems and devices, may not be translated into effective enhancements. They are obtained not only through the implementation of single telemedicine services, but integrating them in a wider digital ecosystem, where clinicians are supported in different clinical steps they have to perform.

The present work defines a novel methodological framework based on organizational, clinical and technological innovation, in order to redesign the territorial care for people with chronic diseases. This innovative ecosystem applied in the Italian research project TALIsMAn is based on the concept of a continuum of care and digitalization of CPs supported by Business Process Management System and telemedicine services. The main goal is to organize the different socio-medical activities in a unique and integrated IT system that should be sustainable, scalable and replicable.

Lean Six Sigma (LSS) implementation follows a structured approach called define-measure-analyze-improve-control (DMAIC). Earlier research about its application in emergency healthcare services shows that it requires organizational transformation, which many healthcare setups find difficult. The Kotter change management model facilitates organizational transformation but has not been attempted in LSS settings till now. This study aims to integrate the LSS framework with the Kotter change management model to come up with an integrated framework that will facilitate LSS deployment in emergency health services.

Two-stage Delphi method was conducted by using a literature review. First, the success factors and barriers of LSS are investigated, especially from an emergency healthcare point of view. The features and benefits of Kotter's change management models are then reviewed. Subsequently, they are integrated to form a framework specific to LSS deployment in an emergency healthcare set-up. The elements of this framework are analyzed using expert opinion ratings. A new framework for LSS deployment in emergency healthcare has been developed, which can prevent failures due to challenges faced by organizations in overcoming resistance to changes.

The eight steps of the Kotter model such as establishing a sense of urgency, forming a powerful guiding coalition, creating a vision, communicating the vision, empowering others to act on the vision, planning for and creating short-term wins, consolidating improvements and producing still more change, institutionalizing new approaches are derived from the eight common errors that managers make while implementing change in the institution. The study integrated LSS principles and Kotter’s change management model to apply in emergency care units in order to reduce waste and raise the level of service quality provided by healthcare companies.

The present study could contribute knowledge to the literature by providing a framework to integrate lean management and Kotter's change management model for the emergency care unit of the healthcare organization. This framework guides decision-makers and organizations as proper strategies are required for applying lean management practices in any system.

The proposed framework is unique and no other study has prescribed any integrated framework for LSS implementation in emergency healthcare that overcomes resistance to change.

Turnover intention (TOI) has become a severe issue in Saudi Arabia’s health-care system as health professionals leave their organizations. Saudi Arabia’s health-care professionals’ TOI affects the organizations and the patients’ human rights. Therefore, this study aims to assess the factors that affected Saudi Arabia’s health-care professionals’ TOI.

This study based its findings on quantitative cross-sectional data. This study’s respondents were health-care professionals working in Saudi Arabia’s public and private health-care institutions.

By using path analysis, this study’s findings reveal that, on the one hand, job stress (JS), psychological distress (PD) and perceived work exhaustion (PWE) have positive and significant effects on TOI. On the other hand, perceived organizational support (POS) is a positive and significant predictor of TOI.

This study’s findings will help the Saudi Arabian Ministry and policymakers develop policies to encourage health professionals’ perseverance through reducing their JS, PD and PWE and by enhancing POS for health-care staff. Moreover, by controlling the increasing turnover ratio among Saudi Arabia’s health-care professionals, this study’s findings assist in overcoming the violations of human rights.

This study’s findings empirically confirm the development of TOI through JS, PD and PWE among Saudi Arabia’s health-care professionals.

Business intelligence (BI) systems and tools are deemed to be a transformative source with the potential to contribute to reshaping the way different healthcare organizations’ (HCOs) services are offered and managed. However, this emerging field of research still appears underdeveloped and fragmented. Hence, this paper aims to reconciling, analyzing and synthesizing different strands of managerial-oriented literature on BI in HCOs and to enhance both theoretical and applied future contributions.

A literature-based framework was developed to establish and guide a three-stage state-of-the-art systematic literature review (SLR). The SLR was undertaken adopting a hybrid methodology that combines a bibliometric and a content analysis.

In total, 34 peer-review articles were included. Results revealed significant heterogeneity in theoretical basis and methodological strategies. Nonetheless, the knowledge structure of this research’s stream seems to be primarily composed of five clusters of interconnected topics: (1) decision-making, relevant capabilities and value creation; (2) user satisfaction and quality; (3) process management, organizational change and financial effectiveness; (4) decision-support information, dashboard and key performance indicators; and (5) performance management and organizational effectiveness.

To the authors’ knowledge, this is the first SLR providing a business and management-related state-of-the-art on the topic. Besides, the paper offers an original framework disentangling future research directions from each emerged cluster into issues pertaining to BI implementation, utilization and impact in HCOs. The paper also discusses the need of future contributions to explore possible integrations of BI with emerging data-driven technologies (e.g. artificial intelligence) in HCOs, as the role of BI in addressing sustainability challenges.

This study aims to investigate the implementation of lean human resource management (HRM) practices in manufacturing small- and medium-sized enterprises (SMEs) and explore how various factors interact to influence their successful adoption. By exploring the interplay among these factors, the research seeks to identify key drivers affecting the adoption of lean HRM in manufacturing SMEs. Ultimately, the research intends to provide insights that can guide organisations, practitioners and policymakers in effectively implementing lean HRM practices to enhance operational efficiency, workforce engagement and competitiveness within the manufacturing SME sector.

The study combined total interpretive structural modelling (TISM) and Matrice d'Impacts Croisés Multiplication Appliquée à un Classement (MICMAC) analysis. TISM helped in understanding the hierarchical relationship among different factors influencing lean HRM implementation, whereas MICMAC analysis provided insights into the level of influence and dependence of each factor on others.

The research revealed that “top management support” emerged as the most independent factor, indicating that strong support from top management is crucial for initiating and sustaining lean HRM practices in manufacturing SMEs. On the other hand, “employee involvement and empowerment” was identified as the most dependent factor, suggesting that fostering a culture of employee engagement and empowerment greatly relies on the successful implementation of lean HRM practices.

While the study provided valuable insights, it has certain limitations. The research was conducted within the specific context of manufacturing SMEs, which might limit the generalizability of the findings to other industries. Expert opinions introduce subjectivity in data collection. Additionally, the study may not cover all critical factors, allowing room for further exploration in future research.

The findings have practical implications for manufacturing SMEs aiming to implement lean HRM practices. Recognising the pivotal role of top management support, organisations should invest in cultivating a strong leadership commitment to lean HRM initiatives. Furthermore, enhancing employee involvement and empowerment can lead to better adoption of lean HRM practices, resulting in improved operational efficiency and overall competitiveness.

This research contributes to the field by offering a comprehensive exploration of the interplay among factors influencing lean HRM implementation. The use of TISM and MICMAC analysis provides a unique perspective on the relationship dynamics between these factors, allowing for a nuanced understanding of their roles in the adoption of lean HRM practices in manufacturing SMEs. The identification of “top management support” as the most independent and “employee involvement and empowerment” as the most dependent factors adds original insights to the existing literature.

The paper aims to investigate the practices facilitating the transformation of healthcare services, understanding the resulting outcomes in terms of well-being and uplifting changes. a systematic literature review (SLR) focusing on analyzing the healthcare sector under the transformative service research (TSR) theoretical domain is conducted to achieve this goal.

Employing a structured SLR developed based on the PRISMA protocol (Pickering and Byrne, 2014; Pickering et al., 2015) and using Scopus and WoS databases, the study identifies and analyzes 49 papers published between 2021 and 2022. Content analysis is used to classify and analyze the papers.

The SLR reveals four transformative practices (how) within the healthcare sector under the TSR domain, each linked to specific well-being outcomes (what). The analysis shows that both practices and outcomes are mainly patient-related. An integrative framework for transformative healthcare service is presented and critically examined to identify research gaps and define the trajectory for the future development of TSR in healthcare. In addition, managerial implications are provided to guide practitioners.

This research is among the first to analyze TSR literature in the context of healthcare. The study critically examines the TSR’s impact on the sector’s transformation, providing insights for future research and offering a roadmap for healthcare practitioners to facilitate uplifting changes.

This study aims to endeavor to discern the predominant leadership styles used by nursing managers within the framework of Slovenian primary health centers. Using a quantitative research approach, the study was conducted through the administration of a structured questionnaire.

The investigation encompassed 67 nursing managers, representing the entire spectrum of primary health centers in Slovenia. A stratified representative subset comprising 53 top nursing managers actively participated in this study.

The prevailing leadership style among nursing managers predominantly manifests as the “integrated” style, characterized by a balanced emphasis on both interpersonal relationships and task-oriented elements. These nursing leaders exhibited a proclivity for fostering collaborative teamwork, with their leadership approach notably shaped by traits such as positive thinking, self-assuredness, comprehensive leadership knowledge and an intrinsic motivation to guide and inspire individuals. Notably, leadership knowledge emerged as the most influential factor in determining the selected leadership style. The study’s findings recognize specific areas in which leadership competencies among nurse managers may require further enhancement and development.

The study’s findings are based on a specific subset of nursing leaders in a particular region, which can add to the originality, especially as there is limited prior research in this specific context. The study’s exploration of leadership styles is original in the sense that it provides insights into the leadership behaviors and traits of nursing managers in the given context. The emphasis on factors such as positive thinking and leadership knowledge as influential elements adds originality to the study.

The emergence of COVID-19 has exacerbated and spurred the growth of mental health issues in ways that have challenged mental health workers tremendously. The complex nature of COVID-19 has made the need of mental health professionals extremely important. Hospital ward overcrowding, social distancing requirements, sequestrations, limits to face-to-face consultations have created barriers to mental health access, especially those in need of Certified Peer Recovery Specialists. Certified Peer Recovery Specialists play a critical role in the treatment of mental illness through their support and engagement of those recovering from substance abuse. Many in this role are hired because they have a strong skillset for help-oriented clinical work but are often challenged, especially in times like this to development and demonstrate leadership skills. This paper explores the nature and need to develop leadership skills and leadership challenges for people in this field through interpretative phenomenological analysis (IPA) and a content analysis of the current and seminal literature.

This paper explores the nature and need to develop leadership skills and leadership challenges for people in mental health through IPA and a content analysis of the current and seminal literature.

The essential necessity to invest in the cultivation of peer recovery specialists and mental health professionals as organizational leaders.

Hospital ward overcrowding, social distancing requirements, sequestrations, limits to face- to- face consultations have created barriers to mental health access, especially those in need of Certified Peer Recovery Specialists. Certified Peer Recovery Specialists play a critical role in the treatment of mental illness through their support and engagement of those recovering from substance abuse.

This study aims to validate a model to assess the level of lean maturity of Brazilian hospitals based on the adaptation of the SAE J4000/2021 standard.

The methodology was divided: (1) adaptation of the standard to the health context, (2) application of the questionnaire through a survey, and (3) comparison of the results of the level of maturity in the standard and by the clustering technique, using Minitab.

The research presents two contributions: (1) validation of a model to assess the level of lean maturity based on the SAE J4000/2021; (2) insights into the level of maturity of Brazilian hospitals. It was observed that only 10% of the sample was classified at maturity level 3 and 75% at level 2. Private and large hospitals showed greater maturity compared to the others.

This includes the limited number of hospitals that participated in the survey, given the difficulty of adherence to due constraints of time and staffing from hospitals, during the COVID-19 pandemic.

This article presents a lean maturity assessment proposal, adapting a consolidated standard in the automobile industry to the health context. Insights on the lean maturity of Brazilian hospitals can contribute to the development of policies to encourage the implementation of the lean philosophy directed to each specific environment.

This study serves as a guide for public agents interested in monitoring the quality of hospital indicators through the SAE J4000/2021 standard. From this lean maturity analysis, hospital managers can understand their opportunities for improvement in both human and organizational aspects. This favors the improvement of service delivery to society that depends on health services.

Due to the lack of research that validates lean maturity level assessment models in Brazilian hospitals, this study can be considered a pioneer in this Brazilian research by validating the SAE J4000/2021 standard in its updated version in the health context.

Drawing upon the stimulus-organism-response model, this study aims to explore the impact of soft aspects of service quality on revisit intention through the mechanism of perceived empathy.

For the examination of the hypothesized relationships, the study adopts structural equation modelling to analyse the data of 562 respondents (i.e. 281 family members and 281 inpatients).

The empirical results suggest that service quality increased family member empathy perception, which, in turn, improved inpatients’ revisit intentions.

Past studies have focused on the roles of overall service quality. The authors have extended the literature by examining the specific but important aspect of service quality and its effects on emotional response. Importantly, the study explains that the affective reactions of a patient’s family, fastened with perceived empathy, have a central role in influencing the patients’ subsequent reactions. Moreover, the prior studies collected the data either from hospital employees or patients. However, in the present study, the authors used a unique sample (family members as well as patients) to have a deeper understanding. Thus, the study enhances the literature on the stimuli-response (i.e. service quality – revisit intentions) relationship in the context of service marketing in general and health care in specific. Important academic and managerial contributions and recommendations for future research are discussed.