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In this chapter, we identify three distinct transformational performance improvement (TPI) approaches commonly used to redesign work processes in health care organizations. We describe the unique components or tools that each approach uses to improve the delivery of health services. We also summarize what is empirically known about the effectiveness of each TPI approach according to systematic reviews and recent studies published in the peer-reviewed literature. Based on examination of this research, we discuss what knowledge is still needed to strengthen the evidence for whole system transformation. This involves the use of conceptual frameworks to assess and guide implementation efforts, and facilitators and barriers to change as revealed in a recent evaluation of one major initiative, the Lean Enterprise Transformation (LET) at the Veterans Health Administration. The analysis suggests ways in which TPI facilitators can be developed and barriers reduced to improve the effectiveness and sustainability of quality initiatives. Finally, we discuss appropriate study designs to evaluate TPI interventions that may strengthen the evidence for their effectiveness in real world practice settings.

Intrapreneurship (IP) and Strategic Human Resource Management (SHRM) are a paradigm in which the current global scenario of increased homeoffice and professional globalization can have the capacity to stimulate professionals’ autonomy and new business orientations able to re-invent new strategies, services, technologies and even leadership development. This study, of an exploratory nature, aims to analyze the synchronicities between IP and SHRM, raised by relational dynamics translated into leadership, organizational culture and individual practices having as a facilitating factor technology as an agent of change for continuous improvement (based on the Kaizen philosophy). It is supported by a qualitative analysis through a case study of a leading Portuguese group, Grupo Salvador Caetano, which has been in existence for 75 years.

The results demonstrate that dynamic relations are the synchronicities of IP and SHRM as long as stimulated and transmitted to collaborators, and that technology, facilitated these processes. The flexibility of SHRM, the sequence of delegation and implementation of relational dynamics must be the key for the synchronicities of SHRM and IP to be two phenomena that go side by side and contribute to more effective performance and evolution among collaborators, as they support each other in creating firms’ value for customers. Some contributions to theory and practice, raised through a logic of “in-house entrepreneurship,” are also presented at the end of the study.

The purpose of this chapter is to critically evaluate contemporary Japanese human resource management (HRM) practices in order to identify if Japanese small enterprises are employing the same or different practices that have been used in the past.

An interpretative qualitative approach is applied through the use of semi-structured interviews. Three small business owners with 30–50 years’ experience in the construction industry have been interviewed in Japanese with their subsequent responses translated, transcribed and coded.

It has been discovered that traditional HRM practices remain popular although their influence has slightly dissipated. This finding indicates an influence by western HR practices, at least to an extent. Findings include the presence of lifetime employment, seniority systems, Kaizen (quality management), the growing international workforce, unionisation, ‘nomunication’, recruitment practices, group decision-making and the lack of gender equality.

Research was only carried out with three small business owners which may reduce the transferability and generalisability of the findings. Only the construction industry was analysed. Moreover, the interviews took place on Skype rather than in a face-to-face environment which may have reduced the ability to effectively understand facial signals.

Although a native Japanese speaker carried out the translations, there may have been issues regarding selecting the most appropriate words to be used.

This study provides an original viewpoint on contemporary HR practices in Japan. It is argued that this chapter will provide a fresh understanding on HRM practices used by Japanese small business and will be useful for scholars, employees and employers alike.