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Open Access
Article
Publication date: 22 September 2021

Anna Tiso, Maria Crema and Chiara Verbano

The paper aims at enriching the knowledge of the application of lean management (LM) in emergency department (ED), structuring the methodology for implementing LM projects and…

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Abstract

Purpose

The paper aims at enriching the knowledge of the application of lean management (LM) in emergency department (ED), structuring the methodology for implementing LM projects and summarizing the relevant dimensions of LM adoption in ED.

Design/methodology/approach

In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, a systematic literature review has been performed, extracting a database of 34 papers. To answer the research purpose, a descriptive and content analyses have been carried out.

Findings

The descriptive analysis demonstrates that the dealt topic is worldwide emerging and multidisciplinary as it arouses interest by medical and engineering communities. Despite the heterogeneity in the adopted methodology, a framework can be grasped from the literature review. It points out the phases and activities, the tools and techniques and the enablers to be considered for guiding the developing of LM project in ED.

Originality/value

This paper provides a comprehensive overview on how to adopt LM in ED, contributing to fill in the gap emerged in the literature. From a practical perspective, this paper provides healthcare managers with a synthesis of the best managerial practices and guidelines in developing a LM project in ED.

Details

Journal of Health Organization and Management, vol. 35 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 5 September 2016

Maria Crema and Chiara Verbano

In a context where healthcare systems have to face multiple challenges, the development of a methodology that combines new managerial approaches could contribute to pursue and…

1502

Abstract

Purpose

In a context where healthcare systems have to face multiple challenges, the development of a methodology that combines new managerial approaches could contribute to pursue and achieve multiple objectives. Inside the research stream that intends to combine health lean management (HLM) and clinical risk management (CRM), the purpose of this paper is to study the significant features that characterize HLM projects obtaining patient safety improvements (L&S projects).

Design/methodology/approach

The novelty of the research implies to adopt qualitative research methodology, analyzing in-depth case studies. L&S projects at different organizational levels have been selected from the same hospital. Following a research protocol, data have been collected through semi-structured interviews and they have been triangulated studying reports and archival documentation.

Findings

Comparing the three cases, it emerges that HLM can be a support for CRM since safety improvements can be achieved solving organizational issues. Analyzing the significant features of the three cases, relevant differences have been highlighted among them. At the end, first indications useful for achieving safety improvements from lean project implementation have been grasped.

Originality/value

This research provides a preliminary contribution to a new research stream that aims to develop a synergic methodology combining HLM and CRM. The first provided indications can be followed by hospital managers who wish to learn how to implement projects achieving patient safety improvements besides efficiency enhancement. After testing and exploiting the obtained results, a new methodology should be developed moving toward a safer and more sustainable healthcare system.

Details

International Journal of Quality & Reliability Management, vol. 33 no. 8
Type: Research Article
ISSN: 0265-671X

Keywords

Article
Publication date: 15 June 2015

Maria Crema, Chiara Verbano and Maria Laura Chiozza

The purpose of this paper is to investigate the significant features that characterize these projects: organizational aspects, phases and activities, tools, techniques, practices…

Abstract

Purpose

The purpose of this paper is to investigate the significant features that characterize these projects: organizational aspects, phases and activities, tools, techniques, practices and key factors for successful implementation. No studies in the academic literature have yet focused on the relation between healthcare lean management (HLM) and clinical risk management (CRM) to enhance multiple aspects of performance, although the possibility of implementing “lean & safety” projects has been highlighted.

Design/methodology/approach

Two significant projects have been selected from the same Italian hospital in two different fields of application. Within- and cross-case analyses have been performed to obtain useful findings.

Findings

The results suggest that HLM can provide support for CRM, and an integrated methodology should be considered. The first indications concerning how this new synergistic methodology may be developed are provided and these should stimulate future research, testing and exploiting the methodology in other contexts.

Originality/value

From the results of this paper, guidelines for the implementation of a “lean & safety” project could be developed to improve the management of clinical processes pursuing multiple objectives. This study could contribute to the development of safer and more sustainable health care systems for the benefit of the entire community.

Details

International Journal of Quality and Service Sciences, vol. 7 no. 2/3
Type: Research Article
ISSN: 1756-669X

Keywords

Article
Publication date: 7 September 2015

Maria Crema and Chiara Verbano

The purpose of this paper is to describe the Italian state of art of Health Lean Management (HLM) and to analyze the Italian projects that connect this approach with clinical risk…

Abstract

Purpose

The purpose of this paper is to describe the Italian state of art of Health Lean Management (HLM) and to analyze the Italian projects that connect this approach with clinical risk management (CRM).

Design/methodology/approach

After introducing Italian healthcare system and its main challenges, relevant Italian experiences have been searched investigating regional health plans (RHPs), managerial reports, books, workshops, conference proceedings and hospital web sites. The degree of experience of each Italian region has been first studied. Further, field of applicability, objectives, tools, practices and results of the projects with first signs of HLM and CRM integration have been analyzed.

Findings

Although interest in new managerial approaches is spreading in almost all the territory and new managerial solutions are fostered in many RHPs, HLM projects are implemented patchy in Italy. For what regards HLM projects with CRM connections, the Italian context seems aligned with the international one, apart from few features. First indications for the implementation of HLM projects with CRM connections emerged.

Originality/value

Healthcare systems are facing multiple challenges in a context where public funds decrease but quality of care must be guaranteed. Combining different managerial approaches could solve these issues. In this research, for the first time, a map about Italian HLM adoption has been drawn, and Italian HLM projects with CRM connections have been analyzed. The results constitute one of the first contributions useful to develop guidelines for the implementation of projects pursuing efficiency, quality and safety objectives.

Details

Business Process Management Journal, vol. 21 no. 5
Type: Research Article
ISSN: 1463-7154

Keywords

Article
Publication date: 13 May 2014

Maria Crema, Chiara Verbano and Karen Venturini

The purpose of this paper is to analyze the linkages between company’s strategy, open innovation and innovation performance, focusing on small and medium enterprises (SMEs). In…

3740

Abstract

Purpose

The purpose of this paper is to analyze the linkages between company’s strategy, open innovation and innovation performance, focusing on small and medium enterprises (SMEs). In more detail, the aim is to investigate the influence of firm strategy on the level of openness adopted and then the impact of open innovation on firm performance. Finally, the influence of context-specific variables (such as firm size, technology intensity, geographical area, experience of the company and technology turbulence) on the relations mentioned above will be verified.

Design/methodology/approach

A survey has been conducted in the Italian manufacturing context and a database of 107 responses was obtained. The constructs of the research framework were created and validated using factor analysis; further, structural equation modeling was performed to verify the hypothesis about the studied relations.

Findings

The obtained model confirmed most of the relations hypothesized, giving useful indications on how to define competitive strategy and coherent level of open innovation to pursue improved firm performance. Results highlight that firms, which pursue an innovative strategy are those who invest more on technical skills and core competencies. Companies who choose a strategy of diversification are likely to use, exclusively, managerial practices of open innovation, while firms focused on a strategy of efficiency are inclined toward open innovation practices and, to a lesser extent, to the development of core competencies.

Originality/value

The main original contribution is the development of an integrated model that links company’s strategy, open innovation and innovation performance in SMEs.

Details

Measuring Business Excellence, vol. 18 no. 2
Type: Research Article
ISSN: 1368-3047

Keywords

Article
Publication date: 12 October 2015

Maria Crema and Chiara Verbano

The purpose of this paper is to investigate connections and overlaps between health lean management (HLM) and clinical risk management (CRM) understanding whether and how these…

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Abstract

Purpose

The purpose of this paper is to investigate connections and overlaps between health lean management (HLM) and clinical risk management (CRM) understanding whether and how these two approaches can be combined together to pursue efficiency and patient safety improvements simultaneously.

Design/methodology/approach

A systematic literature review has been carried out. Searching in academic databases, papers that focus not only on HLM, but also on clinical errors and risk reduction, were included. The general characteristics of the selected papers were analysed and a content analysis was conducted.

Findings

In most of the papers, pursing objectives of HLM and CRM and adopting tools and practices of both approaches, results of quality and, particularly, of safety improvements were obtained. A two-way arrow between HLM and CRM emerged but so far, none of the studies has been focused on the relationship between HLM and CRM.

Originality/value

Results highlight an emerging research stream, with many useful theoretical and practical implications and opportunities for further research.

Details

International Journal of Health Care Quality Assurance, vol. 28 no. 8
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 9 February 2015

Chiara Verbano and Maria Crema

Energy commodities are characterised by rigid demand and high price volatility, linked to many variables such as climate factors, exchange rates, availability of resources. At the…

1808

Abstract

Purpose

Energy commodities are characterised by rigid demand and high price volatility, linked to many variables such as climate factors, exchange rates, availability of resources. At the same time, the authorities often set prices, so wholesale energy companies need to create margins carefully by managing the procurement process and selecting appropriate tools to manage the risks associated with the volatility of energy prices. The purpose of this paper is to analyse and evaluate price and volume risks in the energy procurement process considering a “non-speculative” point of view, which is understudied in the literature review.

Design/methodology/approach

The paper adopts a quantitative approach to risk evaluation, based on accounting indicators, and applies it to a large Italian energy wholesale company.

Findings

A set of key risk indicators to measure price and volume risks is presented in the results, split into synthesis risk, unbalanced risks, modulation risks and risks derived from bilateral contracts. These indicators are applied to the case study, and each risk is prioritised and discussed.

Originality/value

This contribution is one of the first attempts to analyse energy procurement risks in a non-speculative approach. The proposed method allows: first, to evaluate and prioritise the three major types in the energy procurement process, second, to observe the trend of risk exposure, third, the performance measurement of the procurement process, and fourth, benchmarking activities if widely implemented in the energy sector.

Details

International Journal of Productivity and Performance Management, vol. 64 no. 2
Type: Research Article
ISSN: 1741-0401

Keywords

Content available
Article
Publication date: 12 October 2015

Keith Hurst

129

Abstract

Details

International Journal of Health Care Quality Assurance, vol. 28 no. 8
Type: Research Article
ISSN: 0952-6862

Book part
Publication date: 18 April 2016

Max Visser

In the past decades, Dutch public sector organizations (PSOs) have been encouraged to become more “business-like” in their internal control and accountability processes, following…

Abstract

Purpose

In the past decades, Dutch public sector organizations (PSOs) have been encouraged to become more “business-like” in their internal control and accountability processes, following a more general trend toward New Public Management (NPM) in Western societies. However, in the Netherlands, this trend has met with increasing resistance and discontent among public sector professionals. In this chapter, a framework is developed that enables these public sector professionals themselves to discuss and reflect on their internal control and accountability processes, and possibly to effect changes in it.

Methodology/approach

The chapter contains a critical analysis of existing research on management control, accountability, and learning in PSOs and describes a reflection and discussion session with a group of senior staff employees at a Dutch university, employing the framework developed in this chapter.

Findings

It is argued that, generally speaking, the “business-like” approach of NPM does not appear appropriate for most public sector activities and may even negatively affect accountability and learning in PSOs.

Social implications

The chapter critically assesses the impact of NPM on PSOs and provides an alternative to NPM in the form of experimentalist governance, with possible positive implications for the effectiveness of public sector activities.

Originality/value

This chapter is among the first to adapt a framework, developed for scientific and descriptive use, for more practical and prescriptive purposes, that is, as an instrument for public sector professionals to discuss and reflect on their internal control and accountability processes.

Details

Governance and Performance in Public and Non-Profit Organizations
Type: Book
ISBN: 978-1-78635-107-4

Keywords

Article
Publication date: 24 November 2023

Abdulkader Zairbani and Senthil Kumar Jaya Prakash

The purpose of this paper is to provide an organizing lens for viewing the distinct contributions to knowledge production from those research communities addressing the impact of…

Abstract

Purpose

The purpose of this paper is to provide an organizing lens for viewing the distinct contributions to knowledge production from those research communities addressing the impact of competitive strategy on company performance in general, and the influence of cost leadership and differentiation strategy on organizational performance in detail.

Design/methodology/approach

The research methodology was based on the PRISMA review, and thematic analysis based on an iterative process of open coding was analyzed and then the sample was analyzed by illustrating the research title, objectives, method, data analysis, sample size, variables and country.

Findings

The main factor that influenced the competitive strategy is strategic growth; strategic growth has a significant influence on competitive strategy. Furthermore, competitive strategy will boost firm network, performance measurement and organization behavior. In the same way, the internal goal factor will enhance organizational effectiveness. Also, a differentiation strategy will support management practice factors, strategic positions, product price, product characteristics and company performance.

Originality/value

This study contributes to the literature by identifying a framework of competitive strategy factors, company performance factors, cost leadership strategy factors, differentiation strategy factors and competitive strategy with global market factors. This study provides a complete picture and description of the resulting body knowledge in competitive strategy and organizational performance.

Details

Benchmarking: An International Journal, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1463-5771

Keywords

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