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This study aims to present Lean Six Sigma (LSS) deployment and sustainment strategies for the healthcare sector from a multi-level perspective. The objective is to present LSS implementation insights to enable policymakers, practitioners and academicians to test and develop an LSS framework for healthcare sectors.

The strategies identified are the result of a multi-method research design involving literature review, action research (AR) and Delphi study. Further, the AR portion of the study involved more than 10 years of projects focused on the deployment of LSS in the healthcare sector.

The strategies include a holistic view from the multi-level perspective, considering the Top Management Level, Middle Management Level and Operational Level. The authors ascertained 27 strategies across the three levels of organizational structure for the effective deployment of LSS. Further, the authors present a customized LSS “pocket guide” from the healthcare perspective for quick reference.

The strategies delineated in this study are based on the Indian healthcare section only; thus, further research in additional geographic contexts is needed. Also, further research is necessary to provide additional empirical validation of the effects of the identified strategies on LSS program outcomes and to verify that the strategies operate at the proposed organizational levels. Future research should also focus on identifying the interrelationships between strategies within and across levels, developing a “road map” for LSS implementation in hospitals and designing the LSS curriculum for medical schools and other medical training programs.

Observations of this study can contribute to developing a holistic framework for successful LSS implementation in the healthcare sector for academicians, practitioners and policymakers. This, in turn, ensures an enhanced value proposition, improved quality of life and reduced healthcare operational costs. Thus, it ensures a win-win situation among all the stakeholders of the healthcare sector.

The strategies put forth will enable the LSS researchers, academicians and, more particularly, practitioners to delve deeper into specific enablers and safeguard the LSS deployment from backlash. The research has two significant benefits. Firstly, it enhances the understanding of LSS from the healthcare perspective. Secondly, it provides direction for future studies with specific components for hospitals’ LSS framework, which can be further tested, refined and improved.

The coronavirus (COVID-19) pandemic has led to a surge in demand for health-care facilities, medicines, vaccines and other health-care items. The purpose of this study is to investigate different facets of integrated Green Lean Six Sigma and Industry 4.0 approach in the context of COVID-19 for better healthcare management. Integrating Green Lean Six Sigma (GLSS) and Industry 4.0 (I4.0) has the potential to meet the modern demand of health-care units and also leads to improving the quality of inpatient care with better safety, hygiene and real-time diagnoses. A systematic review has been conducted to determine the tools/techniques, challenges, application areas and potential benefits for the adoption of an integrated GLSS-I4.0 approach within health-care facilities from the perspective of COVID management. Further, a conceptual framework of integrated GLSS-I4.0 has been proposed for better COVID management.

To conduct the literature review, the authors used the preferred reporting items for systematic reviews and meta-analysis and covers relevant papers from the arrival of COVID-19. Based on the systematic understanding of the different facets of the integrated GLSS-I4.0 approach and through insights of experts (academicians and health-care personnel), a conceptual framework is proposed to combat COVID-19 for better detection, prevention and cure.

The systematic review presented here provides different avenues to comprehend the different facets of the integrated GLSS-I4.0 approach in different areas of COVID health-care management. In this study, the proposed framework reveals that the Internet of Things, big data and artificial intelligence are the major constituents of I4.0 technologies that lead to better COVID management. Moreover, integration of I4.0 with GLSS aids during different stages of the COVID management, right from diagnosis, manufacture of items and inpatient and outpatient care of the affected person.

This study provides a significant knowledge database to the practitioners by understanding different tools and techniques of an integrated approach for better COVID management. Moreover, the proposed framework aids to grab day-to-day information from the affected people and ensures reduced hospital stay with better space utilization and the creation of a healthy environment around the patient. This inclusive implementation of the proposed framework will enhance knowledge base in medical areas and provides different novel prospects to combat other medical urgencies.

To the best of the authors’ knowledge, this study is the first of its kind to review different facets of the integrated GLSS-I4.0 approach with a view of the COVID health-care perspective and provides a conceptual framework.

Green lean six sigma (GLSS) is a sustainable development approach that leads to improved patient care with improved safety and quality of service to patients. This study aims to identify, study, model and analyze GLSS success factors for the Indian health-care facility.

Interpretive structural modeling (ISM) and Impact Matrix Cross-Reference Multiplication Applied to a Classification analyses have been used to understand the hierarchical structure among the GLSS success factors. This enabled the development of dependency relationships between success factors, in particular, which factors support the development of other factors.

Specifically, this study found that the success factors “commitment of management” and “financial availability” are the most critical to GLSS implementation success, as they support the development of all other success factors. Meanwhile “embedding sustainable measures at each stage of the service”; “the capability and effectiveness of real-time data collection”; and “feedback and corrective actions” most directly support the GLSS implementation in the health-care facility and serve as the final indicators of implementation progress.

The major implication of this research work lies in suggesting a direction for practitioners to execute the GLSS approach through a systematic understanding of classification and structural relationships among different enablers. This study also facilitates health-care managers to explore different GL wastes in hospitals and challenges to sustainability pursuits in health-care that assist in an organization’s efforts toward sustainable development.

This research work is the first of its kind that deals with the identification and analysis of the prominent factors that foster the inclusive implementation of GLSS within the health-care facility.

This paper examines the depth, erudition, and rigor of contemporary research on knowledge management as a causal factor that influences the ultimate outcome of multinational corporation (MNC) expansion, bounded by the confines of information and communication technology (ICT) competences identified as behavioral, business, and technological. Through discussion highlighting the dominant knowledge management (KM) research themes within the milieu of the global firm, readers will gain definitive and practical insight into relevant topics that may be used to stimulate development of growth strategies for the firm.

This article aims to explore the meanings of positionality and demonstrate how reflective memos can illustrate positionality in a constructivist grounded theory (CGT) study.

Acknowledging the positionality of the researcher through a reflective approach is an essential element of CGT studies. The first author (IS) used reflective memoing in her CGT study on Indian immigrant children's asthma to practice reflexivity and make her positionality explicit. Through memos, IS acknowledges her knowledge, beliefs, practices, experience and pre-existing assumptions about the research topic. This article is a compilation of the reflective memos that IS wrote during the initial phase of her research and draws on her motivations as they relate to the topic under study in the context of current literature.

The reflective accounts of a researcher's background and experience can act as a lens for understanding the research question and the choice of methodology.

This article may be useful to novice qualitative researchers who are struggling to define and establish their own positionality. John Dewey's and David Schon's works on reflective thinking serve as valuable tools to practice reflexivity. Philosophically underpinned reflections in the form of memos, employed from the outset and throughout the study, can enhance the study rigour by making research decisions transparent.

This article provides practical guidance on how to outline positionality at the outset of a CGT study.

With the growth of worldwide e‐commerce, companies are increasingly targeting foreign online consumers. However, there is a dearth of evidence as to whether global consumers prefer to browse and buy from standardized global web sites or web sites adapted to their local cultures. This study provides evidence from five different countries as to whether global consumers prefer local web content or standardized web content. The study also measures how the degree of cultural adaptation on the web affects consumer perception of site effectiveness.

The purpose of this paper is to understand Indian consumers’ intention to use mobile payments by examining their adoption readiness (AR) in the larger context of their technology readiness (TR) and their privacy concerns (PCs).

A four-city, three language, paper and pencil survey yielded a sample of 600 respondents from India. Data were analyzed using structural equations modeling.

This study finds that AR positively mediates the relationship between TR and intention to adopt (IA) mobile payments. More importantly, PCs negatively moderate the relationship between AR and IA.

Results will vary depending on country and other variables outside the scope of this study such as perceived risk, trust, etc. The sample was large but mainly comprised males, between 18 and 35 years of age.

The cash shortage due to a recent demonetization move in India had spurred mobile payment adoption but usage and retention remained low. Many other banking self-service technologies had not been successful and digitization was critical for easing payments and potentially paving the way for mobile banking. However, using mobile phones for financial transactions raises PCs that attenuate the positive impact of AR. Also, understanding overall attitudes with TR is important in a rapidly digitizing country with relatively novice users.

Adoption of mobile payment technology can help address social and economic challenges in India, such as financial inclusion, corruption and tax evasion. Given the increasing awareness of privacy issues in India, mobile payment adoption, which already faces acquisition and retention challenges, will likely to face greater resistance in the future.

The findings add to the literature on emerging markets and marketing of technology products by identifying the critical role of privacy in the adoption of financial technology services. Moreover, the authors demonstrate that given the rapid introduction of technology in India, consumers’ overarching TR has to be considered along with AR for mobile payments. Thus, the authors offer a tripartite, customer–technology–transaction view of the mobile payment adoption process in India.

Evidence suggests that hospitals are having problems achieving continuous improvement project (CIP) goals or sustaining their results. Therefore, the purpose of this paper is to identify those critical success factors (CSFs) most strongly related to CIP success in hospitals (Lean-Kaizen project, Lean Six Sigma project, Six Sigma projects, and Quality Improvement projects).

A retrospective survey was applied to any CIP leaders/facilitators from hospitals that conducted at least one CIP during the last two years.

Three main findings were obtained from the 116 valid responses. First, the level of importance of 47 out of 53 CSFs to achieve CIPs success in hospitals was assessed as very important or higher (4 or higher on a six-point scale). Second, there are important differences between the CSFs to achieve CIP success in hospitals in this research and previous investigations. Third, the type of CIP affects the level of importance of 16 out of 53 CSFs to achieve CIP success in hospitals.

Practitioners involved with CIPs activities in hospitals could use the knowledge extracted from this investigation to improve the impact of their CIPs. Future research should continue in two lines: test if the 53 CSFs for CIPs measure a unique factor and identify the main relationships or paths between CSFs for CIPs and CIP outcomes.

The purpose of this paper is to communicate the findings of an empirical research project based on a real world problem that involved the development of a continuous professional development (CPD) framework for a children’s integrated service workforce. In addition, to give attention to the notion that children’s integrated services have not necessarily been viewed from the perspective of conflict management and that this has meant ensuing conflicts that characterise such organisations are more often than not ignored.

A case study approach involving a mixed methodology consisting of semi-structured interviews for senior managers and service leads; a quantitative survey for frontline practitioners and focus groups for service users, carers and children.

Rather than the service being fully integrated, services were aligned, and this was reflected in the conflict between professional cultures, reinforcing an “us and them” culture. This culture had seemingly permeated all aspects of the organisation including the senior management team. It was also noted that certain systems and processes, as well as bureaucracy, within the service were seen as hindering integrated working and was in effect a catalyst for conflict.

What has become evident during the course of this empirical study is the need to further explore the functioning of children’s integrated services using conflict management theories, tools and techniques so as to understand how best to manage conflict to an optimum where an environment of creativity and productiveness is created.

Therefore, when devising a CPD framework it can be argued that there is a need to address some of the types of conflict at the micro-frontline practitioner level of the organisation, as it is this level where there is opportunity through a variety of mechanisms, for example formal and non-formal learning, ring-fenced time, attendance at conferences, team away days and shadowing opportunities can be used to achieve a greater understanding of professional roles, improve working relationships and engage in the division of tasks in a fashion that will promote collaborative working.

The extent to which a children’s integrated service can be the harbinger of a range of multi-faceted conflicts that include the jarring of professional cultures, task conflict, inter-personal incompatibilities and competing value bases cannot be underestimated. Therefore, when devising a CPD framework it can be argued that there is a need to address some of the types of conflict at the micro-frontline practitioner level of the organisation.

Through the application of conflict management theory it will be illustrated how conflict could be used to effectively steer children integrated services towards creativity and productivity through an organisational wide framework that not only embraces dissonance, but also promotes a learning environment that takes advantage of such dissonance to incorporate a hybrid of professional practice and expertise.

The purpose of this study was to examine the level of sponsorship awareness of season ticket holders and the change in the awareness over the duration of one American collegiate football season through a sponsorship recall survey. The results showed that there were increases in the recall rates for eight of the nine actual sponsor companies used in the study from the beginning to the end of the season; however, only three of these differences were statistically significant.