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This paper aims to “identify,” “analyse” and “categorise” the readiness factors of lean sustainability in health-care organisation using total interpretive structural modelling (TISM).

To obtain the data, a closed-ended questionnaire was used in addition to a scheduled interview. To identify how the factors interact, the TISM approach was used, and the matriced’ impacts croise’s multiplication applique’e a UN classement (MICMAC) analysis was used to rank and categorise the lean sustainability readiness factors.

This study identified ten lean sustainability readiness factors for health-care organisation. The identified factors are resources utilization practice (F1), management commitment and leadership (F2), operational flexibility (F3), workforce engagement and time commitment (F4), sustainability motivational factors (F5), awareness of lean and sustainable practice (F6), hospital design (F7), energy efficiency practices in hospitals (F8), responsible autonomy (F9) and new system adoptability training (F10). The key/driving factors are identified in this study are operational flexibility, sustainability motivational factors, management commitment and leadership, new system adoptability training.

The study focussed primarily on lean sustainability factors for the health-care sector.

This research will aid key stakeholders and academics in the better understanding the readiness factors that influence lean sustainability in health-care organisation. This study emphasises the factors that must be considered when applying lean sustainable practices in health care as a real-world application in a health-care organisation. These readiness factors for lean sustainability can be used by an organization to comprehend more about the concept and the components that contribute to health-care lean sustainability.

This study proposes the TISM technique for health care, which is a novel attempt in the subject of lean sustainability in this sector.

This paper aims to examine lean thinking in medical commodities supply chains by considering its applications and success factors. It determines the drivers and wastes of medical commodity supply chain, and the existing lean tools and practices together with their application in the supply chain processes. The paper also examined the challenges and success factors for effective lean application in the medical commodities supply chains.

The study used qualitative approaches, in-depth interviews and focus group discussions with key informants to form the basis for data collection. Through thematic analysis, the collected data were analyzed by developing themes reflecting the objectives of the study.

The main drivers for waste associated with the supply chain were demand management, supplier development, institutional framework and governance. The wastes were observed at the level of inventory, operation costs, transaction costs, delays in terms of service, commodity delivery time and quality. Digitalization, information technology and standardization were the tools for medical supply chain. Poor infrastructure, unreliable internet supply, environmental uncertainty and poor management support were challenges to realizing an effective supply chain.

Although the qualitative approach used in the study provides detailed information, a quantitative study covers a larger sample for generalization.

Capacity building and professionalism should be given a priority because the philosophy of lean focuses on waste removal and continuous improvement, which highly depends on the quality of human resource (Brito et al., 2020). Limited human resource capabilities in supply chain management will, therefore, result into poor operational efficiency, which are wasted. Moreover, systems interoperability is key waste minimization and, therefore, demands interventions.

The government under the Ministry of Health and other key sector ministries such as local and regional governments should better understand the role of the waste drivers and adopt system-wide reforms to support improvements to remove waste in the medical supply chain. For example, the current institutional framework creates an administrative block and hence leads to wastes. This bureaucratic procedure should be removed to minimize wastes along the chain.

This study is among the first studies to determine applicability and implementation of lean in a resource-constrained context. The paper identifies contextual factors for lean implementation. This paper focused on a holistic view of the entire supply chains to enhance a well-functioning supply chain in delivering health commodities.

The present research aims to understand how the literature on lean leadership is currently structured. For this, the thematic subdivisions within the subject (thematic clusters) are analyzed as well as the networks between authors and the authors' countries and the chronological co-occurrence of terms over the years.

The research strategy chosen was a bibliometric analysis conducted with documents collected from the Scopus scientific database. After screening, 192 documents were analyzed using the Vosviewer software.

The main result is related to identifying four thematic clusters. The first cluster is connected to the manufacturing and supply chain industry, and this showed an increasing concern with sustainability, agile manufacturing and digitalization. The second is related to small and medium-sized companies in which Lean concepts, often associated with Six Sigma ideas, present as differentials for competitive advantage. The third one is associated with the civil construction segment, in which there is a great need for cultural and organizational change. The fourth cluster focuses on health organizations. In all clusters, leadership plays a key role.

Besides the contributions to the literature on the theme, this study provides interesting insights for managers regarding the path the managers' sectors are taking in the Lean leadership context.

There are no studies that critically examine Lean leadership literature. This research identifies clusters on the theme, showing how Lean leadership is being addressed by international research.

The various quality improvement (QI) frameworks and maturity models described in the health services literature consider some aspects of QI while excluding others. This paper aims to present a concerted attempt to create a quality improvement maturity model (QIMM) derived from holistic principles underlying the successful implementation of system-wide QI programmes.

A hybrid methodology involving a systematic review (Phase 1) of over 270 empirical research articles and books developed the basis for the proposed QIMM. It was followed by expert interviews to refine the core constructs and ground the proposed QIMM in contemporary QI practice (Phase 2). The experts included academics in two academic conferences and 59 QI managers from the New Zealand health-care system. In-depth interviews were conducted with QI managers to ascertain their views on the QIMM and its applicability in their respective health organisations (HOs).

The QIMM consists of four dimensions of organisational maturity, namely, strategic, process, supply chain and philosophical maturity. These dimensions progress through six stages, namely, identification, ad-hoc, formal, process-driven, optimised enterprise and finally a way of life. The application of the QIMM by the QI managers revealed that the scope of QI and the breadth of the principles adopted by the QI managers and their HOs in New Zealand is limited.

The importance of QI in health systems cannot be overstated. The proposed QIMM can help HOs diagnose their current state and provide a guide to action achieving a desirable state of quality improvement maturity. This QIMM avoids reliance on any single QI methodology. HOs – using the QIMM – should retain full control over the process of selecting any QI methodology or may even cherry-pick principles to suit their needs as long as they understand and appreciate the true nature and scope of quality overstated. The proposed QIMM can help HOs diagnose their current state and provide a guide to action achieving a desirable state of quality improvement maturity. This QIMM avoids reliance on any single QI methodology. HOs – using the QIMM – should retain full control over the process of selecting any QI methodology or may even cherry-pick principles to suit their needs as long as they understand and appreciate the true nature and scope of quality.

This paper contributes new knowledge by presenting a maturity model with an integrated set of quality principles for HOs and their extended supply networks.

Theory of Constraints (TOC), though a well-established process improvement methodology in manufacturing, is still a novel philosophy for healthcare and an exhaustive review of literature is needed to summarize the key findings of various researchers. Such a review can provide a direction to the researchers and academicians interested in exploring the application of TOC in the healthcare sector. This paper aims to review the existing literature of TOC tools and techniques applied to the healthcare environment, and to investigate motivating factors, benefits and key gaps for identifying directions for future research in the domain of healthcare.

In this paper, different electronic repositories were searched using multiple keywords. The current study identified 36 articles published between January 1999 to mid-2021 to conceptualize and summarize the research questions used in the study. Descriptive analysis along with pictorial representations have been used for better visualization of work.

This paper presents a thorough literature review of TOC in healthcare and identifies the evolution, current trends, tools used, nature of services chosen for application and research gaps and recommends future direction for research. A variety of motivating factors and benefits of TOC in healthcare are identified. Another key finding of this study is that almost all implementations listed in literature reported positive outcomes and substantial improvements in the performance of the healthcare unit chosen for study.

This paper provides valuable insight to researchers, practitioners and policymakers on the potential of TOC to improve quality of services, flow of patients, revenues, process efficiency and cost reduction in different health care settings. A number of findings and suggestions compiled in the paper from literature study can be used for diagnosing, learning and making substantial changes in healthcare. The methodologies used by different researchers were analysed and combined to propose a generic step by step procedure to apply TOC. This methodology will guide the practising managers about the appropriate tools of TOC for their specific need.

Good health is always the first desire of all men and women around the globe. The global aim of healthcare is to quickly cure more patients and ensure healthier population both today and in future. This article will work as a foundation for future applications of TOC in healthcare and guide upcoming applications in the booming healthcare sector. The paper will help the healthcare managers in serving a greater number of patients with limited available resources.

This paper provides original collaborative work compiled by the authors. Since no comprehensive systematic review of TOC in healthcare has been reported earlier, this study would be a valuable asset for researchers in this field. A model has been presented that links various benefits with one another and clarifies the need to focus on process improvement which naturally results in these benefits. Similarly, a model has been presented to guide the users in implementation of TOC in healthcare.

This study aims to investigate the implementation of lean human resource management (HRM) practices in manufacturing small- and medium-sized enterprises (SMEs) and explore how various factors interact to influence their successful adoption. By exploring the interplay among these factors, the research seeks to identify key drivers affecting the adoption of lean HRM in manufacturing SMEs. Ultimately, the research intends to provide insights that can guide organisations, practitioners and policymakers in effectively implementing lean HRM practices to enhance operational efficiency, workforce engagement and competitiveness within the manufacturing SME sector.

The study combined total interpretive structural modelling (TISM) and Matrice d'Impacts Croisés Multiplication Appliquée à un Classement (MICMAC) analysis. TISM helped in understanding the hierarchical relationship among different factors influencing lean HRM implementation, whereas MICMAC analysis provided insights into the level of influence and dependence of each factor on others.

The research revealed that “top management support” emerged as the most independent factor, indicating that strong support from top management is crucial for initiating and sustaining lean HRM practices in manufacturing SMEs. On the other hand, “employee involvement and empowerment” was identified as the most dependent factor, suggesting that fostering a culture of employee engagement and empowerment greatly relies on the successful implementation of lean HRM practices.

While the study provided valuable insights, it has certain limitations. The research was conducted within the specific context of manufacturing SMEs, which might limit the generalizability of the findings to other industries. Expert opinions introduce subjectivity in data collection. Additionally, the study may not cover all critical factors, allowing room for further exploration in future research.

The findings have practical implications for manufacturing SMEs aiming to implement lean HRM practices. Recognising the pivotal role of top management support, organisations should invest in cultivating a strong leadership commitment to lean HRM initiatives. Furthermore, enhancing employee involvement and empowerment can lead to better adoption of lean HRM practices, resulting in improved operational efficiency and overall competitiveness.

This research contributes to the field by offering a comprehensive exploration of the interplay among factors influencing lean HRM implementation. The use of TISM and MICMAC analysis provides a unique perspective on the relationship dynamics between these factors, allowing for a nuanced understanding of their roles in the adoption of lean HRM practices in manufacturing SMEs. The identification of “top management support” as the most independent and “employee involvement and empowerment” as the most dependent factors adds original insights to the existing literature.

This study aims to investigate whether Industry 4.0 digital technologies can enhance the effects of lean production on social performance.

Survey data collected from China’s manufacturing industry are used to test research hypotheses.

The results reveal that the three dimensions of lean production (internal, customer and supplier) have a significant positive effect on social performance and that digital technology advancement (DTA) positively moderates these relationships. DTA adds only a marginal contribution to social performance.

This study addresses a new challenging question from manufacturing firms: how to integrate lean, technology and people? The empirical findings provide timely and insightful practical guidance for managers to better understand the role of digital transformation in the traditional lean context.

While digitalization is known to complement lean production, this study shows digitalization also complements the effects of lean production on social performance.

Digital lean implementation can solve the dual problem of stagnating quality and rising costs in healthcare. Although technology adoption in healthcare has increased in the post-COVID world, value unlocking using technology needs a well-thought-out approach to achieve success. This paper provides a prescriptive framework for successfully implementing digital lean in healthcare.

This study uses a mixed-method approach to achieve three research objectives. Whilst it uses a narrative review to identify the enablers, it uses qualitative thematic analysis techniques to categorise them into factors. The study utilises the delphi method for the thematic grouping of the enablers in the broader groups. The study used an advanced ordinal priority approach (OPA) to prioritise these factors. Finally, the study uses concordance analysis to assess the reliability of group decision-making.

The study found that 20 identified enablers are rooted in practice factors, followed by human resource management (HRM) factors, customer factors, leadership factors and technology factors. These results further counter the myth that technology holds the utmost significance in implementing digital lean in healthcare and found the equal importance of factors related to people, customers, leadership and best practices such as benchmarking, continuous improvement and change management.

The study is the first of its kind, providing the prescriptive framework for implementing digital lean in healthcare. The findings are useful for healthcare professionals and health policymakers.

Lean Six Sigma in public and private healthcare organisations has received considerable attention over the last decade. Nevertheless, such process improvement methodologies are not generalizable, and their effective implementation relies on contextual variables. The purpose of this study is to explore the readiness of Italian hospitals for Lean Six Sigma and Quality Performance Improvement (LSS&QPI), with a focus on gender differences.

A survey comprising 441 healthcare professionals from public and private hospitals was conducted. Multivariate analysis of variance was used to determine the mean scores on the LSS&QPI dimensions based on hospital type, gender and their interaction.

The results showed that public healthcare professional are more aware of quality performance improvement initiatives than private healthcare professionals. Moreover, gender differences emerged according to the type of hospital, with higher awareness for men than women in public hospitals, whereas for private hospitals the opposite was true.

This study contributes to the Lean Six Sigma literature by focusing on the holistic assessment of LSS&QPI implementation.

This study informs healthcare managers about the revolution within healthcare organisations, especially public ones. Healthcare managers should spend time understanding Lean Six Sigma as a strategic orientation to promote the “lean hospital”, improving processes and fostering patient-centredness.

This is a preliminary study focussing on analysing inter-relationship between perceived importance of soft readiness factors such as gender dynamics as a missing jigsaw in the current literature. In addition, the research advances a holistic assessment of LSS&QPI, which sets it apart from the studies on single initiatives that have been documented to date.

This study explores the intricate relationship between inventory leanness, financial constraints and digital transformation in listed Chinese manufacturing firms.

Using a large panel data collected from 2,563 Chinese listed manufacturing enterprises over the period from 2012 to 2021, this research employs the instrumental variable method combined with two-stage least squares estimators to explore the U- shaped relationship between inventory leanness and financial constraints. Furthermore, the moderating role of digital transformation is demonstrated.

Contrary to traditional assumptions, our research uncovers a U-shaped relationship between inventory leanness and financial constraints, indicating that excessive inventory reduction can exacerbate financial constraints. Digital transformation plays a significant moderating role, particularly in highly digitalized environments.

Our findings have practical significance for top managers and policymakers. We advocate for a balanced approach to lean inventory management to mitigating financial constraints. The study emphasizes the pivotal role of digital transformation in alleviating the impact of inventory leanness on financial constraints, highlighting the need for digital transformation strategies.

This research provides a comprehensive analysis of inventory leanness, financial constraints and digital transformation dynamics. It challenges conventional thinking by revealing the nonlinear nature of the inventory leanness–financial constraints relationship. The concept of moderation highlights the moderating effect of digital transformation. This study offers practical guidance for practitioners and policymakers.