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The objective of this study is to systematically identify, categorize and assess the driving factors and interdependencies associated with various types of healthcare waste. The study specifically focuses on waste that has been managed or is recommended for treatment through the application of Lean Six Sigma (LSS) methodologies.

To accomplish the study’s objectives, interpretive structural modeling (ISM) was utilized. This analytical tool aided in quantifying the driving power and dependencies of each form of healthcare waste, referred to as “enablers,” as well as their related variables. As a result, these enablers were classified into four distinct categories: autonomous, dependent, linkage and drivers or independents.

In the healthcare sector, the “high cost” (HC) emerges as an autonomous variable, operating with substantial independence. Conversely, variables such as skill wastage, poor service quality and low patient satisfaction are identified as dependent variables. These are distinguished by their low driving power and high dependency. On the flip side, variables related to transportation, production, processing and defect waste manifest strong driving forces and minimal dependencies, categorizing them as independent factors. Notably, inventory waste (IW) is highlighted as a salient issue within the healthcare domain, given its propensity to engender additional forms of waste.

Employing the ISM model, along with comprehensive case study analyses, provides a detailed framework for examining the complex hierarchies of waste existing within the healthcare sector. This methodological approach equips healthcare leaders with the tools to accurately pinpoint and eliminate unnecessary expenditures, thereby optimizing operational efficiency and enhancing patient satisfaction. Of particular significance, the study calls attention to the key role of IW, which often acts as a trigger for other forms of waste in the sector, thus identifying a crucial area requiring focused intervention and improvement.

This research reveals new insights into how waste variables are structured in healthcare, offering a useful guide for managers looking to make their waste-reduction strategies more efficient. These insights are highly relevant not just for healthcare providers but also for the administrators and researchers who are helping to shape the industry. Using the classification and ranking model developed in this study, healthcare organizations can more easily spot and address common types of waste. In addition, the model serves as a useful tool for practitioners, helping them gain a deeper, more detailed understanding of how different factors are connected in efforts to reduce waste.

Although healthcare and healthy living are integral to the Sustainable Development Goals (SDGs) for 2030, the coronavirus epidemic has dealt a devastating blow to these efforts. As governments and policymakers were compelled to shift their focus to lockdowns, sustenance, procurement, and distribution of vaccines, the momentum for health initiatives slowed, and the already fragile health systems of emerging markets were subjected to additional shocks. However, in many underserved regions of the globe, the introduction of technology has greatly facilitated the distribution and adoption of healthcare services.

This chapter highlights mini-cases from four emerging nations: Bangladesh, Nigeria, Vietnam, and the Philippines. Although the countries are emerging, each one of them are in a distinct stage of development and face a unique set of healthcare-related challenges. The chapter showcases how four different organizations based in these countries leveraged the use of technology to take healthcare services to underserved populations. In doing so, they addressed the key challenges of imparting healthcare: geographic accessibility, availability, financial accessibility, and acceptability.

This chapter concludes with a discussion of the implications of expanding healthcare industries leading to increased healthcare waste. To prevent mass population exposure to hazardous substances, the emergence of intelligent healthcare waste collection and disposal systems will be an absolute necessity. Hence, with the development of healthcare services, governments and policymakers need to mechanize smart waste management systems to safeguard humans, animals, and the environment.

A direct correlation exists between waste disposal, disease spread and public health. This article systematically reviewed healthcare waste and its implication for public health. This review identified and described the associations and impact of waste disposal on public health.

This paper systematically reviewed the literature on waste disposal and its implications for public health by searching Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), PubMed, Web of Science, Scopus and ScienceDirect databases. Of a total of 1,583 studies, 59 articles were selected and reviewed.

The review revealed the spread of infectious diseases and environmental degradation as the most typical implications of improper waste disposal to public health. The impact of waste includes infectious diseases such as cholera, Hepatitis B, respiratory problems, food and metal poisoning, skin infections, and bacteremia, and environmental degradation such as land, water, and air pollution, flooding, drainage obstruction, climate change, and harm to marine and wildlife.

Infectious diseases such as cholera, hepatitis B, respiratory problems, food and metal poisoning, skin infections, bacteremia and environmental degradation such as land, water, and air pollution, flooding, drainage obstruction, climate change, and harm to marine and wildlife are some of the public impacts of improper waste disposal.

Healthcare industry waste is a significant waste that can harm the environment and public health if not properly collected, stored, treated, managed and disposed of. There is a need for knowledge and skills applicable to proper healthcare waste disposal and management. Policies must be developed to implement appropriate waste management to prevent public health threats.

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.

This study aims to examine current research on the relationship between Operational Excellence and Healthcare 4.0 (H4.0) for healthcare organizations.

The authors have performed a systematic literature review of 102 documents published between 2011 and 2022 from the Scopus database to identify the research trends on Operational Excellence and H4.0. Through a descriptive bibliometric analysis, this study has highlighted the year-wise trend in publication, top authors, prominent sources of publications, the country-wise spread of research activities and subject area analysis. Furthermore, through content analysis, this study has identified four clusters and proposed directions for future research of each identified cluster.

Results reflect overall growth in this area, with a few parts of the world being underrepresented in research related to Operational Excellence and H4.0. The content analysis focused on describing challenges pertaining to healthcare industries and the role of Operational Excellence tools and H4.0 technologies in dealing with various healthcare delivery aspects. The authors concluded their analysis by proposing a theoretical framework and providing theoretical and managerial implications of the study.

To the best of the authors’ knowledge, the paper is one of the first to analyze the existing literature on the healthcare sector at the interface of Operational Excellence and H4.0 technologies. The conceptual framework and cluster-wise future research prepositions are some of the unique offerings of the study.

The purpose of this study is to solve the problem of healthcare waste management in developing countries. The buildup of medical waste has attracted the attention of all spheres of society due to the expanding population and developing economy. Timely collection and processing of medical waste are extremely important due to its potential hazards. Although the problem of planning medical waste management has been addressed in developed countries, it persists in several developing countries. This research is motivated by an example of a city in India characterized by a dense population, abundant health-care facilities and a lack of planning for managing large medical waste generated daily.

The authors address the problem of designing the network of collection and processing facilities for medical waste and optimizing the vehicle route that collects and transfers the waste between facilities. Due to distinct topographic restrictions in the considered city, the collection and transfer process needs to be conducted in two echelons – from hospitals to collection centers using smaller vehicles and then to the processing facilities using trucks. This work addresses these two problems as a two-echelon location-routing problem.

A mixed-integer programming model is developed to minimize the cost of opening the facilities and transporting medical waste. Several managerial insights are drawn up to assist planners and decision-makers.

This study follows a case study approach to provide a descriptive and prescriptive approach to hospital waste management in the ancient city of Varanasi. The city has witnessed unplanned growth over the years and is densely populated. The health-care facilities in the city have a large catchment area and attract patients from neighboring districts. The situation analysis based on secondary data and unstructured interviews of the stakeholders suggests that the ad hoc approach prevails in present hospital waste management in the city.

Waste management is a crucial aspect of sustainable development, but is it economically sustainable for marginalized informal firms? The study tries to answer this question by revisiting the Porter–Wagner dilemma about the association between environmental management (EM) and firm performance (FP). The study looks into the various liquid waste management practices (LWMPs) adopted by them and the overall impact of LWMPs on firms' economic performance.

The study uses the latest available cross-sectional data source on Indian informal firms by the National Sample Survey Office (NSSO), 73rd survey round 2015–16. First, ordered logistic regression was used to analyse the factors that impact a firm's adoption of a particular LWMP. Subsequently, to capture the heterogeneity among the firms based on productivity and size, a quantile regression (QR) was employed to analyse the impact of LWMPs on firm productivity. Additionally, the propensity score matching technique was used to address endogeneity concerns.

The authors find that bigger, urban-located and female-owned firms adopt cleaner LWMPs that positively impact their economic performance. Furthermore, the QR analysis observed that the most productive firms could extract higher returns from adopting cleaner LWMPs, indicating the relevance of the Porter–Wagner dilemma, i.e. environmental and economic sustainability are possibly symbiotic, thus having a feedback mechanism.

To the authors’ limited knowledge, this is the first study analysing the relationship between EM and FP among the informal sector firms, which are away from any regulations or obligations. Since sustainability is a two-way process, policies should be devised that incentivise sustainable business practices.

The issue of energy efficiency is becoming increasingly prevalent globally due to factors such as the expansion of the population, economic growth and excessive consumption that is not sustainable in the long run. Additionally, healthcare facilities and hospitals are facing challenges as their operational costs continue to rise. The research aim is to develop strategic frameworks for managing green hospitals, towards energy efficiency and corporate governance in hospitals and healthcare facilities.

This research employs a qualitative case study approach, with a sample of ten hospitals examined through interviews with senior management, executives and healthcare facilities managers. Relevant data was also collected from literature and analysed through critical appraisal and content analysis. The research methodology is based on the use of grounded theory research methodologies to build theories from case studies.

The research developed three integrated conceptual strategic frameworks for managing hospitals and healthcare facilities towards energy efficiency, green hospital initiatives and corporate governance. The research also outlined the concepts of green hospitals and energy efficiency management systems and best practices based on the conclusions drawn from the investigated case studies.

The study is limited to the initiatives and experiences of the healthcare facilities studied in the Middle East and North Africa (MENA) region.

The research findings, conclusions, recommendations and proposed frameworks and concepts contribute significantly to the existing body of knowledge. This research also provides recommendations for hospital managers and policymakers on how to effectively implement and manage energy efficiency initiatives in healthcare facilities.

Smart cities in India are going to be a reality very soon by turning challenges into opportunities for the society. However, due to rapid increase in population burden, fast urbanization and growing demand of advanced services in the smart cities, the quantity of per capita municipal solid waste (MSW) has escalated. Moreover, the COVID-19 pandemic has further challenged the municipal solid waste management (MSWM) system with the increasing amount of infectious wastes coming from households (HHs), quarantine centers, healthcare facilities, vaccination centers, etc. Therefore, the present study attempts to explore and analyze the various dimensions of sustainable MSWM system in the smart cities.

The study identifies 13 factors of sustainable MSWM system from the literature, field surveys and stakeholders' opinions. Thereafter, stakeholders' opinions are collected and analyzed using total interpretive structural modeling (TISM) approach to explore the interrelationships among the factors of sustainable MSWM system. These relationships are further validated through the empirical investigation of the real-life case study of Rourkela Municipal Corporation (RMC), Odisha, India.

The TISM approach places all 13 factors into six levels in the hierarchical digraph depending upon the inputs received from the various stakeholders on their interrelationships. Study also validates the proposed TISM model by collecting the data of RMC, Odisha, on the development of MSWM system over the period of 2015–2021.

The study also highlights various implications for the other developing cities and stakeholders to set up the roadmap for developing the sustainable MSWM system. Study defines “IT platform” and “awareness among citizens” as the base of the sustainable MSWM system in any smart city.

The present study is the first of its kind to explore the interrelationships among the factors of sustainable MSWM system by using TISM approach. Moreover, the proposed TISM framework is further validated through the empirical journey of one of the smart cities in India.

The COVID-19 pandemic has affected around 216 countries and territories worldwide and more than 2000 cities in India, alone. The smart cities mission (SCM) in India started in 2015 and 100 smart cities were selected to be initiated with a total project cost of INR 2031.72 billion. Smart city strategies play an important role in implementing the measures adopted by the government such as the issuance of social distancing regulations and other COVID-19 mitigation strategies. However, there is no research reported on the role of smart cities strategies in managing the COVID-19 outbreak in developing countries.

This paper aims to address the research gap in smart cities, technology and healthcare management through a review of the literature and primary data collected using semi-structured interviews.

Each city is unique and has different challenges, the study revealed six key findings on how smart cities in India managed the COVID-19 outbreak. They used: Integrated Command and Control Centres, Artificial Intelligence and Innovative Application-based Solutions, Smart Waste Management Solutions, Smart Healthcare Management, Smart Data Management and Smart Surveillance.

This paper contributes to informing policymakers of key lessons learnt from the management of COVID-19 in developing countries like India from a smart cities’ perspective. This paper draws on the six Cs for the implications directed to leaders and decision-makers to rethink and act on COVID-19. The six Cs are: Crisis management leadership, Credible communication, Collaboration, Creative governance, Capturing knowledge and Capacity building.