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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.

This paper explores Lean Six Sigma principles and the DMAIC (define, measure, analyze, improve, control) methodology to propose a new Lean Six Sigma 4.0 (LSS 4.0) framework for employee occupational exams and address the real-world issue of high-variability exams that may arise.

This study uses mixed methods, combining qualitative and quantitative data collection. A detailed case study assesses the impact of LSS interventions on the exam management process and tests the applicability of the proposed LSS 4.0 framework for employee occupational exams.

The results reveal that changing the health service supplier in the explored organization caused a substantial raise in occupational exams, leading to increased costs. By using syntactic interoperability, lean, six sigma and DMAIC approaches, improvements were identified, addressing process deviations and information requirements. Implementing corrective actions improved the exam process, reducing the number of exams and associated expenses.

It is important to acknowledge certain limitations, such as the specific context of the case study and the exclusion of certain exam categories.

The practical implications of this research are substantial, providing organizations with valuable managerial insights into improving efficiency, reducing costs and ensuring regulatory compliance while managing occupational exams.

This study fills a research gap by applying LSS 4.0 to occupational exam management, offering a practical framework for organizations. It contributes to the existing knowledge base by addressing a relatively novel context and providing a detailed roadmap for process optimization.

The purpose of this study is to examine the critical failure factors (CFFs) linked to various types of process improvement (PI) projects such as Kaizen, Lean, Six Sigma, Lean Six Sigma and Agile. Proposing a mitigation framework accordingly is also an aim of this study.

This research undertakes a systematic literature review of 49 papers that were relevant to the scope of the study and that were published in four prominent databases, including Google Scholar, Scopus, Web of Science and EBSCO.

Further analysis identifies 39 factors that contribute to the failure of PI projects. Among these factors, significant emphasis is placed on issues such as “resistance to cultural change,” “insufficient support from top management,” “inadequate training and education,” “poor communication” and “lack of resources,” as primary causes of PI project failures. To address and overcome the PI project failures, the authors propose a framework for failure mitigation based on change management models. The authors present future research directions that aim to enhance both the theoretical understanding and practical aspects of PI project failures.

Through this study, researchers and project managers can benefit from well-structured guidelines and invaluable insights that will help them identify and address potential failures, leading to successful implementation and sustainable improvements within organizations.

To the best of the author’s knowledge, this paper is the first study of its kind to examine the CFFs of five PI methodologies and introduces a novel approach derived from change management theory as a solution to minimize the risk associated with PI failure.

This study aims to examine the impact of Lean 4.0 practices on value co-creation in the dairy ecosystem.

Data collection were carried out through a questionary application with 126 professionals linked to the dairy ecosystem, including milk producers, milk cooperatives and milk transporters. The data were analyzed using Cluster Analysis, Mann-Whitney test and Chi-Square test.

A strong relation was found between the use of Lean 4.0 tools and the increase in operational performance, in addition to milk quality. Moreover, it can be noted that the use of digital technologies from Industry 4.0 has a strong relation with dairy production optimization, in other words, it is possible to be more efficient in the dairy process via Lean 4.0 adoption.

The study is limited to analyzing the Brazilian dairy ecosystem. The results presented may not reflect the characteristics of the other countries.

Once the potential empirical impacts of the relation between Lean 4.0 and value co-creation are elucidated, it is possible to direct strategies for decision-making and guide efforts by researchers and professionals to deal with the waste mitigation present in the dairy sector.

Lean 4.0 proves to be a potential solution to improve the operational performance of the dairy production system. Lean 4.0, linked to value co-creation, allows the integration of the production sector with consumers, through smart technologies, so new services and experiences can be provided to the consumer market. Additionally, the consumer experience can be stimulated based on Lean 4.0, once the quality specification is highlighted based on data science and smart management control.

To the best of the authors’ knowledge, this is the first study that analyzes the interrelationship between the Lean 4.0 philosophy and the value co-creation in the dairy ecosystem. In this sense, the study reveals the main contributions of this interrelation to the dairy sector via value co-creation, which demonstrates a new perspective on the complementarity of resources, elimination of process losses and new experiences for the user through digital technologies integrated with the Lean Thinking approach.

This study aims to analyze lean wastes for the poultry sector in Turkey and link lean tools to this study, focusing on identifying each lean waste that affects poultry production and proposing solutions for preventing these lean wastes in the sector. The proposed solutions aim to improve processes by suggesting different lean tools and their applications for the poultry sector.

The study consists of two different applications. First, the waste relationship matrix (WRM) was created to reveal the relationship between seven lean wastes and their importance order. Then, after determining lean tools for eliminating lean wastes, the optimum weight ranking and consistency ratio of the most suitable lean tools were calculated for these wastes and ranked with the best-worst method (BWM).

Results showed that overproduction is the most critical waste that impacts other wastes, followed by defect waste. Due to the nature of the sector, these wastes not only result in economic loss for the company but also in food waste and loss and issues related to animal welfare. Furthermore, the Kaizen approach and 5S implementation are the methods to eliminate these wastes. Detailed discussion on the link between lean tools and lean wastes is provided for the poultry sector.

This is the first study that theoretically and empirically identifies the potential lean waste affecting the poultry sector and provides lean tools for eliminating these wastes. Sector-specific explanations and discussions are presented in the study to show the applicability of lean approaches in the poultry sector to eliminate waste. In addition, this study is the first to integrate the WRM and BWM.

Small- and medium-sized enterprises (SMEs) within the construction sector are highly vulnerable to disruptions caused by political and economic decisions or even pandemics. This study evaluated the current operations of selected SMEs providing engineering design and consultancy services against Toyota Production System (TPS) lean tool. The purpose is to juxtapose SME operations and processes with TPS to ascertain the level of their operations conformity to the established TPS lean thinking tool.

This study used a qualitative data collection and analysis approach to evaluate the current processes of participating SMEs against Liker's 14 management principles of TPS. The data collected were analysed using thematic analysis to identify patterns and themes that emerged from the qualitative data.

The analysis revealed that focus on short-term goals, immediate profit and duplication of effort resulting from insufficient collaboration is currently creating waste in participating SMEs' operations. Hence, the implementation of TPS was recommended as a lean tool and a framework based on TPS lean tool was developed for improving the operations of SMEs.

The study is limited to SMEs operating only as consultants providing project planning design within the construction industry. Data collection is limited to qualitative even though observations would improve the outcome of the study.

The study advances contemporary issues in promoting lean implementation in construction sector and developed an improved framework based on the TPS to enhance the performance of SME construction businesses.

The aim of this paper is to explore the implementation of an integrated lean and ISO 14001 approach in meat industry for environmental performance and examine a proposed conceptual framework by capturing insights from lean and ISO 14001 experts in New Zealand (NZ).

Semi-structured interviews have been conducted with a group of consultants (lean and ISO 14001) to evaluate the suitability of an integrated lean and ISO 14001 approach in the meat industry for environmental performance. A conceptual framework from literature has guided this study leading to its further development based on the empirical evidence collected.

Findings have illustrated a synergistic positive impact of lean and ISO 14001 implementation as an integrated approach for sustaining environmental performance in the meat industry. A joint implementation program provides more clarity in aligning ISO 14001 operational procedures with lean tools and techniques for an enhanced environmental performance outcome.

The application of an integrated lean and ISO 14001 framework is proposed in this paper, which can help industry practitioners and academia in developing a joint implementation strategy and conducting future research.

To the best of the author’s knowledge, this study is the first to assess the effective implementation of lean and ISO 14001 as an integrated approach in the NZ meat industry.

The purpose of this study is to explore the relationship between Lean manufacturing and Industry 4.0 for small and medium size of enterprise in Japan and Brazil.

The authors conducted a quantitative survey (20 companies in Japan and 30 companies in Brazil) combined with a qualitative interview (2 companies in Japan and 15 companies in Brazil).

According to the quantitative study, 90% of them practice Lean manufacturing and 40% of them practice Industry 4.0. In the qualitative study in Brazil, four managers responded that the Lean manufacturing is a prerequisite for Industry 4.0 since any production process with waste cannot be productive, even with sophisticated digitalization technology.

The authors explored further the relationship between “defensive Digital Transformation (DX),” which is based mainly on Lean manufacturing, and “offensive DX,” which relates to customer value creation through Industry 4.0. This study clarifies the relationship and plays as a roadmap to develop better the manufacturing from current status to the vision of Industry 4.0.

This paper presents a new and well-structured framework that aims to assess the current environmental impact from a Greenhouse Gas (GHG) emissions perspective. This tool includes a new set of Lean Key Performance Indicators (KPIs), which translates the well-known logic of Overall Equipment Effectiveness in the field of GHG emissions, that can progressively detect industrial losses that cause GHG emissions and support decision-making for implementing improvements.

The new metrics are presented with reference to two different perspectives: (1) to highlight the deviation of the current value of emissions from the target; (2) to adopt a diagnostic orientation not only to provide an assessment of current performance but also to search for the main causes of inefficiencies and to direct improvement implementations.

The proposed framework was applied to a major company operating in the plywood production sector. It identified emission-related losses at each stage of the production process, providing an overall performance evaluation of 53.1%. The industrial application shows how the indicators work in practice, and the framework as a whole, to assess GHG emissions related to industrial losses and to proper address improvement actions.

This paper scrutinizes a new set of Lean KPIs to assess the industrial losses causing GHG emissions and identifies some significant drawbacks. Then it proposes a new structure of losses and KPIs that not only quantify efficiency but also allow to identify viable countermeasures.

This paper aims to introduce a model using a digital twin concept in a cold heading manufacturing and develop a digital visual management (VM) system using Lean overall equipment effectiveness (OEE) tool to enhance the process performance and establish Fourth Industrial Revolution (I4.0) platform in small and medium enterprises (SMEs).

This work utilised plan, do, check, act Lean methodology to create a digital twin of each machine in a smart manufacturing facility by taking the Lean tool OEE and digitally transforming it in the context of I4.0. To demonstrate the effectiveness of process digitisation, a case study was carried out at a manufacturing department to provide the data to the model and later validate synergy between Lean and I4.0 platform.

The OEE parameter can be increased by 10% using a proposed digital twin model with the introduction of a Level 0 into VM platform to clearly define the purpose of each data point gathered further replicate in projects across the value stream.

The findings suggest that researchers should look beyond conversion of stored data into visualisations and predictive analytics to improve the model connectivity. The development of strong big data analytics capabilities in SMEs can be achieved by shortening the time between data gathering and impact on the model performance.

The novelty of this study is the application of OEE Lean tool in the smart manufacturing sector to allow SME organisations to introduce digitalisation on the back of structured and streamlined principles with well-defined end goals to reach the optimal OEE.