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This study demonstrates how becoming a high-reliability institution in health care is a priority, given the high-risk environment in which an error can result in harm. Literature conceptually supports the need for highly reliable health care facilities but does not show a comprehensive approach to operationalizing the concept into the daily workforce to support patients. The Veterans Health Administration closes the gap by documenting a case study that not only demonstrates specific actions and functions that create a high-reliability organization (HRO) for safety and improvement but also created a learning organization by spreading the knowledge to other facilities.

The authors instituted a methodology consisting of assessments, training and educational simulations to measure, establish and operationalize activities that identified and prevented harmful events. Visual communication boards were created to facilitate team huddles and discuss improvement ideas. Improvements were then measured and analyzed for purposeful outcomes and return on investment (ROI).

HRO can be operationalized successfully in health care systems. Measurable outcomes verified that psychological safety was achieved through the identification and participation of 3,184 process improvement projects over a five-year period, which yielded a US$2.8m ROI. Documented processes and activities were used for educational teachings, which were disseminated to other Veteran Affairs Medical Center’s through the Truman HRO Academy.

This case study is limited to one hospital in the Veterans Health Administration (VHA) network. As the VHA continues to deploy the methods outlined to other hospitals, the authors will perform incremental data collection and ongoing analysis for further validation of the HRO methods and operations. Hospitalists can adapt the methods in the case study for practical application in a health care setting outside of VHA. Although the model is rooted in health care, the methods may be adapted for use in other industries.

This case study overcomes the limitations within literature regarding operationalizing HRO by providing actual activities and demonstrations that can be implemented by other health care facilities.

The consulting team intervenes in the integrated construction consulting (ICC) network structure centered on “client-contractor-consultant.” Team boundary-spanning behavior (TBB) driven by the network structure is crucial to project performance. This article investigated how to stimulate the consulting project performance (CPP) improvement by considering the interactive effect of network structure and TBB. To be specific, this paper explored the configuration between structural characteristics of project networks, the dimension of TBB, and project performance in ICC projects.

Network density and centrality were used to reflect network structure. This study collected 216 valid responses from construction professionals (including project managers, department managers, and project engineers) via a questionnaire survey and analyzed the data using fsQCA.

Combining with the corresponding typical project case and analysis, the results concluded four types of configurations for achieving high performance in the ICC projects. Meanwhile, network centrality, density, ambassadorial behavior, coordination behavior, and detection behavior significantly impact high consulting project performance. Matching ICC network characteristics with the TBB is important. There are also three low performance configurations for the ICC projects. Low performance state also occurs when network centrality or density and coordination behavior is simultaneously low. Only the right match between the network characteristics and TBB can produce high consulting project performance.

The network centrality and density, the implementation of TBB vary, and the paths to achieve high consulting project performance are different. Clients, ICC projects, and consulting teams should choose the appropriate development paths according to the actual situation. (1) Clients should commit to applying the ICC project model with high network centrality, density, and coordination behavior of ICC enterprises to promote project performance. (2) Consulting enterprises should carry out ICC business based on detecting behavior and coordinating behavior. (3) The market should cultivate head consulting enterprises with independence and integration, and bring into play the effectiveness of consulting team ambassadorial behavior.

Comparing the results of the four high CPP configurations, the network structure characteristics are essential, which means that in the Chinese consulting practice between the owner and the consulting firm pay attention to the use of appropriate ICC organizational structure model and arrange the degree of centralization of authorized responsibilities. Coordination behavior is necessary to achieve high CPP. Therefore, Chinese consulting firms should pay attention to effective communication and exchange with project contractors in order to get high CPP in conducting business; meanwhile, enabling behavior can achieve high CPP both in the presence and absence of configuration H1 and H4, which indicates that enabling behavior has substitution effect. Comparing the three low CPP configurations also contrarily confirms the indispensability of coordinating behavior. Comparing the results of high and low CPP configurations, the TBB is seriously missing and not properly applied in CPP enhancement. In detail, Chinese consulting firms have been regarded as independent third parties providing services, and less attention has been paid to the TBB of Chinese consulting firms in past practice, thus leading to the dilemma of inadequate empowerment of consulting firms due to their unclear status. To solve this dilemma, the findings of this paper offer a solution at the micro level to change the previous perception of consulting and demonstrate that Chinese consulting practice needs to pay attention to TBB with owners and contractors, and apply it well to enhance the reputation, management consulting level and capability, and experience and expertise of consulting firms to achieve high CPP.

The research results changed from the previous bilateral project governance to a new perspective of network embedding. It provided a theoretical basis for the improvement path of high consulting project performance, as well as providing ideas for clients on the organizational design of ICC projects. On the other hand, it provided a practical reference for TBB positioning of ICC enterprises for transformation and upgrading development.

The purpose of this paper is to investigate and measure stakeholder engagement and interorganisational relationships involved in the project design process.

A mixed-methods design, which combined action study, focus group meetings and a survey with project stakeholders who were employees in this project to express their comments on current design processes in different sub-projects.

The transformation of the design process in the selected project can be categorised into three distinct areas: (1) people, (2) practices and (3) internal infrastructure. These three categories were a straightforward way to review, analyse and discuss this transformation. The findings revealed the major goals of the improvement process as summarised are reliability, efficiency and quality. Recommendations and future study directions were suggested by the end of the paper.

Although the project selected in this research was limited to Australia, the results could be interpreted on the design process in many other construction projects with similar size all over the world.

This research was very practical, with all data collected from the project in Australia. It summarised the difficulties met in the project and provided methods for stakeholders and industry practitioners to improve the effectiveness and efficiency of the design process.

This research provided lessons learnt on the design process from a “Giga” project and provided sustainable methods to facilitate future projects into flexible and effective communication among stakeholders.

Acquainting organisations regarding the concepts of Total Quality Management (TQM) and its implementation is one measure that effectively improves their global position and performance. Kaizen is one of the concepts of TQM, which focuses on low-cost organisational transformational methods and often saves consuming significant resources (time, capital, etc.). Using Kaizen in organisational transformation sets efficient guidelines to improve processes agility and leanness and increase manufacturing productivity. Hence, this study aims to identify the key success factors in Kaizen projects and presents a score function that measures the readiness level of organisations to implement Kaizen projects.

A literature review first extracts the key success factors in Kaizen projects. Afterwards, the selected factors are screened via the fuzzy Delphi method using expert opinions from the manufacturing sector of an emerging economy. Subsequently, their importance is cross-examined by the Bayesian best–worst Method (BBWM). The BBWM is one of the most recent multiple criteria decision-making (MCDM) methods that lead to stable, dynamic and robust pairwise comparisons. After analysing the weights of the key factors, a score function is designed so that organisations can understand how much they are ready to launch Kaizen projects.

According to the findings, “Training and education” and “Employee attitude” played an important role in the success of Kaizen projects. The literature extracted 22 success factors of Kaizen projects, and 10 factors were eliminated through the fuzzy Delphi method. Twelve success factors in Kaizen projects were evaluated and investigated through the BBWM. Matching to this method, “Training and education” and “Employee attitude” weighed 0.119 and 0.112, relatively. Furthermore, “Support from senior management” was the least important factor.

To the best knowledge of the authors, this is the first research in which the success factors of Kaizen projects have been identified and analysed through an integrated multi-layer decision-making framework. Although some studies have investigated the key success factors of Kaizen projects and analysed them through statistical approaches, research that examines the success factors of Kaizen projects through MCDM methods is yet to be reported. Moreover, the score function that measures the level of readiness of each organisation for the successful implementation of Kaizen projects is a unique contribution to this research.

Construction industry is a vital sector for economic and national development. However, the industry suffers buildability problems. Improving construction projects buildability is the duty of every key stakeholder. Thus, this study aims to identify and evaluate the project designers’ roles in improving construction projects buildability in Nigeria.

This study adopted quantitative research method. A purposive sampling approach was used in identifying the representative sample for the administration of the questionnaire survey. A total of 122 questionnaires were distributed to the targeted construction professionals, out of which 93 questionnaires were sufficiently filled and returned, representing a response rate of 76%. This study used descriptive and inferential statistics for data analyses.

The results from factors analysis show that the roles of project designers in improving construction projects buildability in Nigeria can be categorised into two constructs: “discuss fully the design objectives with builders” and “prepare cost effective and buildable designs”.

This study contributed to more effective buildability studies by highlighting the roles of project designers in improving construction projects buildability in the construction industry. An understanding of these roles is vital for reducing buildability problems as well as for improving and embedding buildability as a practice in construction management.

Organisation concepts consist of prescriptive ideas concerning how to manage or organise. The simultaneous use of multiple concepts in an organisation may create synergies but also confusion and conflicts. This paper aims to explore how change agents deal with the simultaneous use of multiple organisation concepts within a single organisation.

A qualitative case study of a Norwegian energy company using lean, agile and design thinking.

The findings show that change agents compare the concepts with each other and recognise commonalities and differences. They also match individual concepts and tools to the nature of tasks, the different phases of projects/initiatives based on their perceived maturity or internal communities. Most agents emphasise similarities between concepts and complementarities between tools. This approach creates a versatile toolbox for improvement.

Companies making use of multiple organisation concepts should continuously discuss and actively manage the tensions that exist between concepts while establishing a unified approach and common culture for improvement.

This study offers a novel understanding of how change agents make sense of different approaches to improvement within a single organisation.

Given the implementation of a new Certified Public Accountant (CPA) licensure exam and the CPA Evolution Model Curriculum, accounting educators must integrate more advanced skills in their coursework. We illustrate how a commonly-used project in accounting classes, which teaches technical accounting content, can address skills and competencies identified by the Pathways Commission and the American Institute of Certified Public Accountants (AICPA) and, as a result, enhance skills all business school graduates need in the workplace.

We incorporate a financial statement analysis research project under a group work format in three levels of financial accounting classes. Using both quantitative and qualitative analysis, we evaluate changes in student perceptions of skills and competencies important for business graduates.

We find students perceive improvement in critical thinking, problem-solving, the ability to work with other people, their understanding of the course material, and data analysis abilities after completion of the project. We also find statistically significant increases pre-to post-project in student perceptions of their knowledge, confidence, competence, and enthusiasm with respect to accounting material.

We provide an example of how educators can align a commonly-used project with the CPA Evolution Model Curriculum, yet still meet the needs of non-accounting majors and prepare all students for future business careers. Group work has been studied and similar financial statement analysis projects have been implemented in the classroom for years. We contribute by not only extending and updating this research, but also by re-evaluating a project to determine whether it meets the shifting needs of a rapidly changing profession. By doing so, we answer recent researchers’ call for research in higher education that addresses employability and workplace skills.

With the continuous improvement of public–private partnership (PPP) projects, the participants' value creation goals are not only limited to achieving the basic performance objectives but also to realising value added. However, the effect of traditional contract management on realising the value creation objectives of PPP projects is limited. According to the view of multifunctional contract, joint-contract functions that integrate contract control and flexibility are likely to be effective in enhancing the value creation of PPP projects. This study aims to explore the effects of joint-contract functions on PPP project value creation and relevant influencing mechanism by investigating the mediating effect of in-role behaviour and extra-role behaviour.

After collecting 258 valid questionnaires from PPP professionals in China, this study used structural equation modelling to validate the hypotheses.

Contract control and flexibility can improve PPP project value creation. Specifically, contract control improves the achievement of the basic contract objectives of PPP projects, whereas contract flexibility enhances the achievement of the value-added of PPP projects. Moreover, only in-role behaviour mediates the effect of contract control on value creation. In addition, the mediating effect of extra-role behaviour on the impact of contract flexibility on value creation is stronger than that of in-role behaviour. The mediating effect of in- and extra-role behaviour is mainly reflected in the realisation of basic and value-added performance, respectively.

The findings of this study can help realise value creation in three ways. Firstly, new perspectives for PPP project value creation should be proposed by combining the improvement of contract objectives and the realisation of the participants' implicit demands. Secondly, the effects of different contract functions on value creation should be analysed instead of a single dimension of contractual governance. Thirdly, the mediating effects of different types of cooperation behaviour that may influence the relationship between contractual governance and value creation should be evaluated.

This study verifies the impacts of different contract functions on PPP project value creation. In addition, cooperative behaviour is embedded as a mediating variable, and the mediated transmission path from contract function to cooperative behaviour and further to PPP project value creation is systematically analysed.

The increasing complexity of civil engineering projects necessitates focusing on new competencies of project participants. Based on the research on team performance and design processes that are more closely linked to the relevance of the project context, it is hypothesised that empathic abilities could play an important role in the performance of civil engineering projects. Therefore, this study aims to investigate whether performance can be improved by focusing on empathic abilities during the integrated design phase.

Semi-structured in-depth interviews with experts were conducted to explore the relevance of empathic abilities and their interaction with performance in a real-life infrastructure project. The project team’s empathy level was measured by means of a survey using Davis’ Interpersonal Reactivity Index method. Finally, differences between expected and measured levels of empathy were analysed.

The results provide insights into how empathic abilities interact with performance. The measurement indicates that, on average, professionals in the civil engineering industry score relatively low on empathy. In addition, differences were identified between the expected distribution and the measured empathy levels of the team, implying a potential for improvement, in particular by increasing the empathic abilities of the project management and increasing gender diversity.

To the best of the authors’ knowledge, this study is the first to investigate a relationship between empathy and the performance of civil engineering projects. The results provide initial insights into the empathic ability of civil engineering project teams and the potential of empathy to improve performance. Furthermore, from an empathy perspective, this study advocates increasing the gender diversity of project teams to improve performance.

This research fills a gap in process science by defining and explaining entropy and the increase of entropy in processes.

This is a theoretical treatment that begins with a conceptual understanding of entropy in thermodynamics and information theory and extends it to the study of degradation and improvement in a transformation process.

A transformation process with three inputs: demand volume, throughput and product design, utilizes a system composed of processors, stores, configuration, human actors, stored data and controllers to provide a product. Elements of the system are aligned with the inputs and each other with a purpose to raise standard of living. Lack of alignment is entropy. Primary causes of increased entropy are changes in inputs and disordering of the system components. Secondary causes result from changes made to cope with the primary causes. Improvement and innovation reduce entropy by providing better alignments and new ways of aligning resources.

This is the first detailed theoretical treatment of entropy in a process science context.