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The impact of the COVID-19 pandemic on healthcare operations has raised questions about the applicability and capacity of the lean approach to respond to critical events. Thus, with a dearth of studies addressing this issue, this study aims to understand the role of lean in healthcare operations under the disruptive impact of the COVID-19 pandemic.

Drawing on a case study carried out in an emergency department in Brazil during the COVID-19 outbreak, the author presents results from semi-structured interviews and document analysis.

The results show three prominent themes that respond to this study's purpose: lean applicability during the pandemic, lean challenges during the pandemic and the pandemic impact on the lean processes. Furthermore, the study underscores that lean is not the panacea to operational problems caused by the pandemic in healthcare organisations, but it eases the impact on their operations. Finally, this study contributes to the discipline of operations management and highlights the need to rethink lean applications during disruptive events, focusing on flexibility, adaptability and patients' needs.

The literature addressing the pandemic impact on healthcare operations is still new and emerging; therefore, it is possible that some of the studies that are under review and could contribute to this study were not considered.

The study provides a better understanding of the lessons learned from the real-world experiences gained during the pandemic, helping managers to make informed decisions when developing contingency plans to improve healthcare readiness and responsiveness under crisis conditions (e.g. untenable demand and constrained capacity).

Given the contemporary nature of this pandemic, only few emerging studies addressing the impact of the pandemic on lean healthcare operations are available and scholars are calling for more empirical studies. Furthermore, there is an increasing criticism and scepticism about the applicability of lean in healthcare during a pandemic. Thus, this research both provides original contributions by responding to scholars' calls for novel research in this area and further contributes towards filling the void in the literature.

The COVID-19 pandemic is considered a major disruptive event of this decade, raising unforeseen socio-economic implications worldwide. This novel virus has increased the influx of patients in hospitals, and healthcare organisations are facing unprecedented constraints in their operations to deal with increased demand and pressed capacity. Thus, this article evaluates the impact of the COVID-19 pandemic on healthcare systems' demand, resources and capacity and provides research directions.

This is a viewpoint article and uses timely information on healthcare operations from both scholars and managers, published by diverse sources during the COVID-19 outbreak.

The authors discuss the focus on “flattening the curve of infection” as a measure to protect healthcare, delay the impact of increased demand and reorientate healthcare supply chain practices. Furthermore, the authors evaluate the role of lean practices on managing demand and capacity and improving quality across healthcare operations and supply chain. Finally, the authors suggest research directions on modern operational issues that emerged during this pandemic, such as discussions around the sustainability of lean post-pandemic, “just in time” practices, inventory trade-offs and lack of organisational responsiveness during untenable events.

In this article, the authors provide a contemporary assessment of the implications of the COVID-19 pandemic on healthcare operations, underscoring main economic and operational elements that can be affected, such as unforeseen demand, resources and capacity shortage. Therefore, the authors assess that healthcare organisations, practitioners and governments have to anticipate operational and economic impacts and, ultimately, to reassess their plans to deal with such adverse events.

The purpose of this paper is to investigate how operations strategy and Lean concepts can be applied within a healthcare organisation and the degree to which both Lean and operations strategy are understood by senior-level National Health Service (NHS) personnel, based on the process of ongoing longitudinal cases studies. Further interviews and data analysis will examine actual performance of Lean capabilities within the NHS.

For this explanatory multiple-case study project the authors collected data through semi-structured interviews with executives in the NHS to understand how operations strategies are developed in the NHS and implemented in NHS hospitals. The unit of analysis is the hospital. Multiple (22) interviews took place over 12 months with senior-level personnel responsible for implementing change via operations strategy goals, and incorporating Lean initiatives. In addition, to triangulate data, the authors examined healthcare reports and strategy policy documents from each case hospital. This forms stage 1 of a longitudinal study which will examine the actual performance of Lean within the NHS hospitals across a range of operations parameters and explore links between such capabilities and the role and importance of operations strategy in more detail.

The findings lead to the conclusion that operations strategies were not fully developed within the hospitals. In addition, the ongoing data capture shows that “Best practice” was not being disseminated across the NHS, for either patient experience or organisational effectiveness and the role of operations strategy was not fully clear other than as a rather vague “umbrella” term. Despite Lean’s attraction for healthcare at a micro-level, significant operational and cultural hurdles must be overcome for the full strategic benefits of Lean to be realised. A much more holistic approach in providing a full service for the whole of the patient journey is needed.

The sample provides an initial snapshot. A larger number of hospitals and/or further longitudinal research will be needed to deepen understanding of embedding strategic change to improve overall performance.

Tackling cultural performance and operational issues at a macro-level could help healthcare providers reconcile the perceived conflicting goals of improving patient care (i.e. service delivery) whilst simultaneously reducing costs. The role of explicit operations strategies could be pivotal in designing and implementing such change.

This research builds on and extends the work of Toussaint and Berry (2013), Seddon and O’Donovan (2010) and Carlborg and Kowalkowski (2013). The authors highlight how some of the apparent contradictions in the requirements of the various stakeholders create operational and strategic tensions. The authors highlight the multi-faceted nature of design and delivery of a multi-touchpoint service within the complexity of a large healthcare provider.

Using total interpretive structural modelling (TISM), this paper aims to “identify”, “analyse” and “categorise” the sustainable-resilience readiness factors for healthcare during the Covid-19 pandemic.

To obtain the data, a closed-ended questionnaire was used in addition to a scheduled interview with each respondent. To identify how the factors interact, the TISM approach was employed and the cross-impact matrix multiplication applied to a classification method was used to rank and categorise the sustainable-resilience readiness factors.

This study identified ten sustainable-resilience readiness factors for healthcare during the Covid-19 pandemic. The study states that the major factors are environmental scanning, awareness and preparedness, team empowerment and working, transparent communication system, learning culture, ability to respond and monitor, organisational culture, resilience engineering, personal and professional resources and technology capability.

The study focused primarily on sustainable-resilience readiness characteristics for the healthcare sector.

This research will aid key stakeholders and academics in better understanding the factors that contribute to sustainable-resilience in healthcare.

This study proposes the TISM technique for healthcare, which is a novel attempt in the subject of readiness for sustainable-resilience in this sector. The paper proposes a framework including a mixture of factors for sustainability and resilience in the healthcare sector for operations.

Globally, the presence of non-urgent patients in emergency departments (EDs) is considered one of the main reasons for creating excessive waiting times and overcrowding in units. This paper aims to understand the impact of non-urgent patients in EDs' operations.

This study is based on qualitative case studies conducted within two Brazilian EDs, and uses interviews and observations to access the data.

From a thematic analysis, three key themes emerged: characteristics of non-urgent demands in EDs, negative aspects of non-urgent patients in EDs, and the impact of the healthcare system model on EDs. These themes bring to light the impact that non-urgent patients have in EDs' operations, and provide theoretical and practical implications.

The limitation of this work is bound by the understanding of the non-urgent demands in EDs. Therefore, a benchmarking approach (investigating state-of-the-art practices to avoid such impact) was not applied but was suggested for future research instead.

The research provides significant contributions to practitioners and policymakers, aiding future discussions to improve healthcare coverage and performance.

The research provides significant contributions for managers and policymakers, aiding future discussions to improve healthcare. For instance, the use of well-known techniques (e.g. lean, six sigma) are discussed and suggested to enhance healthcare capacity and performance. Furthermore, the policymakers are called upon to evaluate the healthcare access and provide regulations that involve innovative approaches to widen healthcare access.

Based upon empirical data, this research extends the discussions related to non-urgent patient in EDs and is not limited merely to descriptive analysis, but by providing practical propositions and discussions related to the impact of these patients' presence in EDs' operations. Finally, the research provides a range of suggestions for future research related to the EDs' operational performance.

Green transformation is more than simply a trend; it is a way of life, a set of habits, a field of knowledge and a dedication to resource conservation. Going green is surely a creative and transformative process for both individuals and organizations. This paper aims to “identify,” “analyse” and “categorise” the readiness factors for green transformation process in health care using total interpretive structural modelling (TISM) and neutrosophic-MICMAC.

To address the study objectives, the study used TISM and neutrosophic-MICMAC analysis. To identify the readiness factors, a literature study was conducted, and the factors were face-validated by the healthcare experts. The factors influence on one another were captured by using a scheduled interview with a closed ended questionnaire. The TISM addressed the identification and analysing of factors and the categorization and ranking the readiness factors is addressed by using neutrosophic-MICMAC analysis.

This study identified 11 green transformation process readiness factors for healthcare organizations. The study states that the key factors or driving factors are awareness of green governance principle, environment leadership and management, green gap analysis, information and communication technology and innovation dynamics.

The factor ranking is sensitive to the respondents’ ratings. The study relied on the past literature and experts’ opinion may result in the subjective biases. The complex nature of healthcare ecosystem challenges to capture all the factors. The study focussed on Indian hospitals.

Study significantly impacts the healthcare practitioners, academicians and policymakers by providing critical insights into the readiness factors required for the healthcare green transformation process. The study offers a better understanding of the crucial or key or driving factors that aid in embracing green and sustainable practices.

Identifying a gap in conceptual and theoretical frameworks for green transformation readiness factors in healthcare organizations and in Indian context. The study addresses this gap by aiming to create a thorough theoretical framework and highlighted by its focus on Indian hospitals.

Worldwide, healthcare systems struggle to sustain the delivery of services at a time of increasing demand, limited resources and growing expectations from users, coupled with dealing with the aftermath of the Covid-19 pandemic and the threat of other outbreaks. There has never been a more important time to sustain innovation and improvements. Using an illustrative case, the authors assess the application of two existing frameworks to identify the key propositions and dimensions required to deliver sustainable services.

This illustrative case study focuses on a service provided by a chronic disease, multidisciplinary community healthcare team in the UK. Experienced-based interviews were conducted with health professionals, patients and relatives to provide a rich account of a care pathway design. A high-level process map is used to visualise the key touch points.

The authors identify all seven propositions of the SERVICE framework being present along with additional dimensions relating to sustaining innovation and improvement.

This research is limited to a chronic disease care pathway. However, the authors believe the results could be applicable to other medical conditions, which are supported by a similar multi-disciplinary service delivery model.

The authors provide a sustainable public service operations SERVICES framework for health professionals and managers to consider when (re)designing care pathways.

This research contributes to the emerging discipline of public service operations research by empirically testing for the first time the SERVICE framework within healthcare. The authors have included additional factors associated with innovation and improvement and recommended further development of the framework to include factors, such as economic sustainability, highly relevant to the context of universal healthcare systems.

The purpose of this paper is to convey a message of preparedness and mitigation to key stakeholders throughout the healthcare community concerning healthcare supply chain readiness and preparedness.

Using a review of existent literature, this work examines and expounds upon the impact of effective supply chain management processes in disaster mitigation and planning.

This paper presents a discourse in supply chain managers' involvement in disaster planning, identifying courses of action, and collaboratively planning for crisis. Logistics is a specific genre of skill sets within healthcare operations.

Key tenets of logistics readiness and preparedness are often missed when developing strategies for disaster mitigation. While this discussion is directed specifically toward healthcare management, the principles are applicable across a wide array of industries.

Disaster affects everyone and is likely to occur in any type of organization. Leaders have an inherent responsibility to plan for both expected and unexpected events; the latter can present complexities that require intuitive reaction provided scenarios have been considered in advance. Arguably, the critical path to success involves effective process management and collaborative communications across multiple echelons of managerial responsibilities.

Few works were found concerning healthcare supply chain management involvement in disaster readiness. In an applied sense, this paper provides healthcare managers with concepts related to effective crisis mitigation.

The purpose of this study is to identify organisational homeostasis factors in the context of healthcare organisations and to develop a conceptual model for green transformation.

The organisational homeostasis factors were determined by review of literature study and the opinions of healthcare experts. Scheduled interviews and closed-ended questionnaires are employed to collect data for this research. This study employed “TISM methodology” and “MICMAC analysis” to better comprehend how the components interact with one another and prioritise them based on their driving and dependence power.

This study identified 10 factors of organisational homeostasis in healthcare organisation. Recognition of interdependence, hormesis, strategic coalignment, consciousness on dependence of healthcare resources and cybernetic principle of regulations are the driving or key factors of this study.

The study's primary focus was on the organisational homeostasis factors in healthcare organisations. The methodological approach and structural model are used in a healthcare organisation; in the future, these approaches can be applied to other industries as well.

The key drivers of organisational homeostasis and the identified factors will be better comprehended and understood by academic and important stakeholders in healthcare organisations. Prioritizing the factors helps the policymakers to comprehend the organisational homeostasis for green transformation in healthcare.

In this study, the TISM and MICMAC analysis for healthcare is proposed as an innovative approach to address the organisational homeostasis concept in the context of green transformation in healthcare organisations.

The purpose of this paper is to synthesise the extent to which lean implementation in healthcare has been studied in the literature since its inception a decade ago.

This paper is based upon a literature review of mostly academic articles published mainly in the fields of operations management and medicine.

The current state of the literature on lean healthcare implementation is primarily evaluative (benefits-oriented), descriptive (process-oriented) and rarely holistic (interaction of lean implementation and clinical practice).

This paper identifies further research directions for academics, and provides an overview of findings relevant to healthcare stakeholders interested in lean implementation.