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A method to engage salient organisational stakeholders in identifying and ranking measures of healthcare improvement programs is described. The method is illustrated using Executive WalkRounds (EWRs) in a multi-site Australian Health District.

Subject matter experts (SMEs) conducted document analysis, identified potential EWRs measures, created driver diagrams and then eliminated weak measures. Next, a panel of executives skilled in EWRs ranked and ratified the potential measures using a modified Delphi technique.

EWRs measurement selection demonstrated the feasibility of the method. Of the total time to complete the method 79% was contributed by SMEs, 14% by administration personnel and 7% by executives. Document analysis revealed three main EWRs aims. Ten of 28 potential measures were eliminated by the SME review. After repeated Delphi rounds the executive panel achieved consensus (75% cut-off) on seven measures. One outcome, one process and one implementation fidelity metric were selected to measure and monitor the impact of EWRs in the health district.

Perceptions of weak relationships between measures and intended improvements can lead to practitioner scepticism. This work offers a structured method to combine the technical expertise of SMEs with the practical knowledge of healthcare staff in selecting improvement measures.

This research describes and demonstrates a novel method to systematically leverage formal and practical types of expertise to select measures that are strongly linked to local quality improvement goals. The method can be applied in diverse healthcare settings.

This purpose of this paper is to examine the application and outcomes of applying all of the seven lean flows to pathology laboratory remodelling as part of a lean rapid improvement event (RIE).

Longitudinal case study of a lean RIE linking emergency and pathology departments focusing on the systematic application of lean's seven flows to the physical environment.

Following the lean RIE, changes improving patient specimen, technician, supplies and information flows avoided 187 km and eight days of unnecessary walking each year.

The difficulty of making accurate comparisons between time periods in a health care setting is acknowledged.

This research provides evidence that applying lean design concepts in a laboratory can make substantial improvements, particularly if the expertise of the people working in the laboratory is trusted to determine the most appropriate changes. Significant amounts of time and motion were saved by just one, easily quantifiable change.

The laboratory staff is processing increased numbers of time-critical tests, yet report a calmer working environment, without any increase in the pace of work. Laboratory personnel also experienced satisfaction in exercising control over their work environment.

To the best of the authors’ knowledge this is the first comprehensive report applying lean flows to pathology laboratory remodelling and one of the few applications of Lean Systems Thinking between departments and between separate health services organisations.

The purpose of this chapter is to explore the interaction between access-based consumption (ABC) and consumer culture in the specific context of baby products, and connect the two streams of consumer research and design theory, by associating ABC with product service systems (PSS) which are seen as desirable as they offer a promise of sustainability.

Within an action research approach consisting of the establishment of a pilot service provision, we conducted ethnographies including in-depth interviews and focus groups.

The adoption of access-based provisions is constrained by low compatibility with consumer culture. Consumers are concerned with the provision’s ability to satisfy their needs, what this mode of consumption says about them, and the extent to which it associates them with communities of practice.

The limitations are the typical ones of action research, which is linked to a unique, researcher-generated context where the researcher is also a participant, and therefore are difficult to generalize.

The large-scale implementation of PSS underpinning ABC is problematic as it challenges consumers’ needs for self-expression and affiliation; however, we found that consumers in this specific context are responsive to the environmental efficiency of PSS.

Our research explores the intersection between consumer research and design, and consumers’ response to sustainable business models which underpin ABC.

Our preoccupation with the Repertory Grid Technique has left little time and attention to the core ideas articulated in Kelly’s (1955) Theory of Personal Constructs. After more than 20 years engaging with the method, I have (re)discovered his theorizing about man’s quest for knowing, to be the most insightful. This chapter shares my reflections/reflexions about the crucial role he placed on the notion of “anticipation.” I position this importance within the context of the challenges of our times and advocate that his “psychology of the unknown” is just as important today as it was 62 years ago.

The ability to measure and assess “quality” is essential in building and maintaining a safe and effective transportation system. Attaining acceptable quality outcomes in transportation projects has been a reoccurring problem at both the federal and state levels, at least partially, as a result of poorly developed, inefficient or nonexistent quality assurance/quality control (QA/QC) processes. The purpose of this paper is to develop and implement a new QA/QC process that focuses on a novel double-bounded performance-related specification (PRS) and corresponding pay factor policy that includes both lower and upper quality acceptance and payment reward boundaries for bridge concrete.

The authors use historical data to design different payment scenarios illustrating likely industry responses to the new PRS, and select the single scenario that best balances risk between the agency and industry. The authors then convert that payment scenario to a pay factor schedule using a search heuristic and determine statistical compliance with the PRS using percent-within-limits (PWL).

The methodology offers an innovative approach for developing an initial set of pay factors when lifecycle cost data are lacking and the PRS are new or modified. An important finding is that, with a double-bounded PRS, it is not possible to represent pay factors using the simplified table PWL currently employed in practice because each PWL value occupies two separate positions in the payment structure – one above the design target and one below it. Therefore, a more detailed set of pay factors must be employed which explicitly specify the mean sample value and the design target. The approach is demonstrated in practice for the Agency of Transportation in state of Vermont.

The authors demonstrate a novel approach for developing a double-bounded PRS and introduce a payment incentive/disincentive policy with the goal of improving total product quality. The new pay factor policy includes both a payment penalty below the contracted price for failing to meet a specified performance criterion as well as a payment premium above the contracted price that increases as the sample product specification approaches an “ideal” design value. The PRS includes both an upper and lower acceptance boundary for the finished product as opposed to only a lower tail acceptance boundary, which is the traditional approach.

The authors illustrate a research collaboration between academia and a state agency that highlights the role academic research can play in advancing quality management practices. The study involves the use of actual product performance data and is operational as opposed to conceptual in nature. Finally, the authors offer important practical insights and guidance by demonstrating how a new PRS and pay factor policy can be developed without the use of site-specific historical lifecycle cost (LCC) data that include detailed manufacturing, producing and placement cost data, as data related to product performance over time. This is an important contribution, as the development and implementation of pay factor policies typically involve the use of historical LCC data. However, in many cases, these data are not available or may be incomplete.

With the new PRS and pay factor schedule, the Agency expects shrinkage and cracking on bridge decks to decrease along with overall maintenance and rehabilitation costs. A major focus the new PRS is to actively involve industry partners in quality improvement efforts.

The authors focus on a major modification to an existing QA/QC process that involves the development of a new PRS and an associated pay factor policy undertaken by the Vermont Agency of Transportation. The authors use empirical data to develop a novel double bounded PRS and payment schedule for concrete and offer unique operational/practical insight and guidance by demonstrating how a new PRS and pay factor policy can be developed without the use of site-specific historical LCC. Typically, PRS for in-place concrete have only a lower tail acceptance boundary.

The purpose of this paper is to describe how an Academic Health Science Centre, providing pediatric rehabilitation services, research, and education, developed a Centres for Leadership (CfL) initiative to integrate its academic functions and embrace the goal of being a learning organization.

Historical documents, tracked output information, and staff members’ insights were used to describe the ten-year evolution of the initiative, its benefits, and transformational learnings for the organization.

The evolutions concerned development of a series of CfLs, and changes over time in leadership and management structure, as well as in operations and targeted activities. Benefits included enhanced clinician engagement in research, practice-based research, and impacts on clinical practice. Transformational learnings concerned the importance of supporting stakeholder engagement, fostering a spirit of inquiry, and fostering leaderful practice. These learnings contributed to three related emergent outcomes reflecting “way stations” on the journey to enhanced evidence-informed decision making and clinical excellence: enhancements in authentic partnerships, greater innovation capacity, and greater understanding and actualization of leadership values.

Practical information is provided for other organizations interested in understanding how this initiative evolved, its tangible value, and its wider benefits for organizational collaboration, innovation, and leadership values. Challenges encountered and main messages for other organizations are also considered.

A strategy map is used to present the structures, processes, and outcomes arising from the initiative, with the goal of informing the operations of other organizations desiring to be learning organizations.

In this paper, I explore what shapes the identities of digital nomads (DNs), a class of remote workers who travel and work concurrently. Through extensive fieldwork and interviews with 50 digital nomads conducted in seven coworking hostels in Mexico in 2022, I construct a theory of DN identity. I base this upon the frequent transformations they undergo in their Circumstances, which regularly change their worker identity.

DNs relinquish traditional social determinants of identity, such as nationality and religion. They define their personal identities by their passions and interests, which are influenced by the people they meet. DNs exist in inherently transitive social spaces and, without rigid social roles to fulfil, they represent themselves authentically. They form close relationships with other long-term travellers to combat loneliness and homesickness. Digital nomads define their worker identities around their location independence. This study shows that DNs value their nomadic lifestyle above promotions and financial gain. They define themselves by productivity and professionalism to ensure the sustainability of their lifestyle. Furthermore, digital nomad coworking hubs serve focused, individual work, leaving workplace politics and strict ‘office image’ norms behind. Without fixed social and professional roles to play, digital nomads define themselves personally according to their ever-evolving passions and the sustainability of their nomadic life. Based on these findings, I present a cyclical framework for DN identity evolution which demonstrates how relational, logistical, and socio-personal flux evolves DN’s worker identities.

The purpose of this paper is to deepen resource-based view theory by analyzing how intellectual capital (IC) affects performance in temporary teams and by showing the moderating role of integrative mechanisms.

The research context focuses on 153 national teams of football (NTF), also referred to as national soccer teams, as an example of temporary groups. A partial least squares (PLS) methodology was utilized on a data set built from transfermarkt.com and FIFA world rankings. Three main hypotheses were developed and tested using first a PLS and then an OLS approach.

The results show how IC contributes to performance, extending the findings of previous studies to the context of temporary teams. Additionally, the results show how some integrative mechanisms such as assembly decisions and team leader experience influence temporary team performance by creating an interaction effect with existing IC.

This study contributes to IC theories for three reasons. First, it applies IC research to a specific research context: temporary teams, where specific organizational capabilities are required to coordinate resources. Second, the study analyzes the role of integrative mechanisms as moderators of the relationship between IC and performance in temporary teams. Third, the study focuses on NTF as an example of temporary teams.