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The purpose of this paper is to identify the areas and logic of integration of different stakeholders using different methods and to analyse their applicability and challenges in practical projects. The main aim is to describe how these different methods impact value creation.

Action design research was carried out in a large hospital construction project where the first author acted as an “involved researcher” and the second author acted as an “outside researcher”. Two workshops were organised to evaluate the direct and indirect challenges and benefits of the applied four methods and to explain how different methods enable value creation.

All the studied methods provide good results in terms of usability and commitment to the aims of the project, thus delivering the direct benefits expected. Process, people and tools logic works well in this case project when applying the methods properly. Significant evidence was provided on secondary deliverables of the methods, and all analysed methods had a significant impact in the area of leading people, clarifying what “focus on people” means and how it is enabled.

Focus on people can be achieved through different operative methods if applied in the right way. It is necessary to select the most suitable methods based on all the direct and indirect deliverables.

This case project offered a platform to analyse integration methods in a real-life project using the collaborative contract method. The authors were able to participate in the analysis by taking action from the very beginning of the project in terms of training, learning, continuous development and coaching of these methods and evaluating the applicability.

The purpose of this paper is to understand if and how industrialized house building (IHB) could support productivity developments for housebuilding on project and industry levels. The take is that fragmentation of construction is one explanation for the lack of productivity growth, and that IHB could be an integrating method of overcoming horizontal and vertical fragmentation.

Singe-factor productivity measures are calculated based on data reported by IHB companies and compared to official produced and published research data. The survey covers the years 2013–2020 for IHB companies building multi-storey houses in timber. Generalization is sought through descriptive statistics by contrasting the data samples to the used means to control vertical and horizontal fragmentation formulated as three theoretical propositions.

According to the results, IHB in timber is on average more productive than conventional housebuilding at the company level, project level, in absolute and in growth terms over the eight-year period. On the company level, the labour productivity was on average 10% higher for IHB compared to general construction and positioned between general construction and general manufacturing. On the project level, IHB displayed an average cost productivity growth of 19% for an employed prefabrication degree of about 45%.

Empirical evidence is presented quantifying so far perceived advantages of IHB. By providing analysis of actual cost and project data derived from IHB companies, the article quantifies previous research that IHB is not only about prefabrication. The observed positive productivity growth in relation to the employed prefabrication degree indicates that off-site production is not a sufficient mean for reaching high productivity and productivity growth. Instead, the capabilities to integrate the operative logic of conventional housebuilding together with logic of IHB platform development and use is a probable explanation of the observed positive productivity growth.

This paper aims to investigate the moderating effect of sustainability reporting on the relationship between the independent variables of board diversity, and earnings management and the dependent variable of readability of financial statements.

The study panel data regression analysis involved 36 Kenyan-listed companies from 2016 to 2020.

Key findings were that increased board diversity was found to significantly improve the readability of financial statements. Discretionary earnings management was found to significantly reduce the readability of financial statements. Sustainability reporting was found to significantly increase the readability of financial statements, and it moderated the relationship between board diversity, earnings management and financial statements readability in Kenya.

The study sample of 36 non-financial listed in the Nairobi Securities Exchange was very small and was affected by the problem of thin trading; hence, caution should be adopted when interpreting the findings.

The Capital Markets Authorities (CMA) as a policymaker should enforce sustainability reporting by Kenyan listed firms as there is evidence that the reporting enhances the readability of financial statements. The Institute of Certified Public Accountants as a policymaker should closely monitor the published financial statements of firms for earnings management and punish the perpetrators, as there is empirical evidence that the practice reduces the readability of financial statements.

Sustainability reporting is successful as a moderating variable between readability of financial statements and determinants of readability of financial statements.

This study contributes to knowledge by studying sustainability reporting as a moderating variable between the independent variables of board diversity and earnings management and the dependent variable of readability of financial statements and measured sustainability reporting using a dummy variable for the period before and after the enactment and release of CMA code of 2016 on corporate governance that required sustainability reporting by Kenyan listed companies.

Value-based healthcare suggested using patient-reported information to complement the information available in the medical records and administrative healthcare data to provide insights into patients' perceptions of satisfaction, experience and self-reported outcomes. However, little attention has been devoted to questions about factors fostering the use of patient-reported information to create value at the system level.

Action research design is carried out to elicit possible triggers using the case of patient-reported experience and outcome data for breast cancer women along their clinical pathway in the clinical breast network of Tuscany (Italy).

The case shows that communication and engagement of multi-stakeholder representation are needed for making information actionable in a multi-level, multispecialty care pathway organized in a clinical network; moreover, political and managerial support from higher level governance is a stimulus for legitimizing the use for quality improvement. At the organizational level, an external facilitator disclosing and discussing real-world uses of collected data is a trigger to link measures to action. Also, clinical champion(s) and clear goals are key success factors. Nonetheless, resource munificent and dedicated information support tools together with education and learning routines are enabling factors.

Current literature focuses on key factors that impact performance information use often considering unidimensional performance and internal sources of information. The use of patient/user-reported information is not yet well-studied especially in supporting quality improvement in multi-stakeholder governance. The work appears relevant for the implications it carries, especially for policymakers and public sector managers when confronting the gap in patient-reported measures for quality improvement.

Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a shift from acute, episodic and reactive hospital-centered care toward longitudinal, person-centered and proactive home-centered care. The purpose of this paper is to contribute to the knowledge of a comprehensive development strategy for designing and providing home-centered care of older people.

The study design is based on qualitative research with an inductive approach. The authors study development initiatives at the national, regional and local levels of the Swedish health and social care system. The data collection methods included interviews (n = 54), meeting observations (n = 25) and document studies (n = 59).

The authors describe findings related to policy actions and system changes, attempts to achieve collaboration, integration and coordination, new forms of care offerings, characteristics of work settings at home and differences in patients' roles and participation at home and in the hospital.

The authors suggest home-centered care as a solution for providing person-centered and integrated care of older people and give examples of how this can be achieved.

The authors outline five propositions for research and development related to national policies, service modularity as a solution for customized and coordinated care, developing human resources and infrastructure for home settings, expanding services that enable older people living at home and patient co-creation.

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.

Prodigious teamwork is the basis for augmenting the level of productivity on construction projects. Globalisation of the construction market has meant that many practitioners work outside of their geographical spectrum; however, the multicultural dissimilarities of construction workforces within the project management team (and how these may impact upon project productivity performance) have been given scant academic attention. To bridge this knowledge gap, this paper aims to analyse the effects of a multicultural workforce on construction productivity.

The epistemological positioning of the research adopted mixed philosophies (consisting of both interpretivism and postpositivism) to undertake a deductive and cross-sectional survey to collate primary quantitative data collected via a closed-ended structured questionnaire. Census sampling and convenience sampling techniques were adopted to target Ghana’s construction workforce and their opinions of the phenomenon under investigation. Out of 96 questionnaires administered, 61 were retrieved. The data obtained were analysed by using mean score ranking, relative important index, one sample t-test and multiple regression. The reliability of the scale was checked by using Cronbach’s alpha coefficient.

From the t-test analysis, 11 variables sourced from extant literature, and the null hypothesis for the study was not rejected and all factors (except high cost of training and improper gender diversity management) were affirmed as negative effects of the multicultural workforce on construction productivity. Using multiple regression analysis, six of the independent variables were shown to impact upon productivity. The goodness of fit was verified by collinearity and residual analysis. The model’s validation revealed a relatively high predictive accuracy (R² = 0. 589), implying that the results could be generalized. In culmination, these findings suggest that the predictors can be used to accurately predict the effects of multicultural workforce on construction productivity performance.

The findings indicate that multicultural workforce/teams have a substantial effect on overall construction productivity in the construction sector; consequently, stakeholders must address this issue to enhance productivity across the sector.

The current study significantly contributes to our understanding of how multicultural workers/teams affect construction productivity in the construction business perspective and how to respond to the negative menace.

The purpose of the study was to produce a healthier, convenient and traditional ready-to-eat (RTE) snack option with increased nutritional value, using spent hen meat, dietary fibre (DF) and simple technological methods. The product was designed to be stable without refrigeration and be easily adoptable by local self-help groups, rural women and youth and entrepreneurs in urban and semi-urban areas.

Conventional binder used for making snacks, i.e. rice flour was partially replaced by different sources of antioxidant DFs, i.e. oat flour (T₁ – 10%), finger millet flour (T₂ – 5%) and amaranth flour (T₃ –15%) to prepare spent hen snack sticks (SHSS). The snacks were then packaged in low density polyethylene (LDPE) pouches and evaluated for their storage stability at ambient temperature for a period of 35 days. Their physico-chemical, sensory and microbiological quality was evaluated at a regular interval of 7 days. The proximate composition of developed SHSS was compared to commercially available snack products (chakli/murukku – snacks without meat).

The fibre-enriched SHSS showed significant improvement in nutritive value, as they contained more fibre (p = 0.001) and protein (p = 0.029) than control SHSS. When compared to commercially available snack product SHSS showed three-fold significant increase in protein (p = 0.000) and ash content (p = 0.001) and only 11%–12% total fat as compared to 31% fat in the market-available product. The most acceptable treatment in terms of overall sensory quality and nutritional aspects was T₃; however, T₂ was more shelf-stable during the storage period. The study showed that fibre-enriched snacks can be stored at ambient temperature for up to 35 days without substantial loss in physico-chemical, sensory and microbial quality. Hence, substituting rice flour with DFs can lead to the development of products with better sensory attributes and improved functionality.

The simplicity of the product in terms of composition, machinery and low production costs makes it an easily adoptable one by small-scale entrepreneurs, especially those belonging to semi-urban areas.

Incorporation of spent hen meat, a relatively cheap but abundant source of protein, in RTE products can serve as an effective way to alleviate protein malnutrition, whereas addition of fibre further improves the functionality of the product. The methodology can be easily taken up by small-scale entrepreneurs and create a market for snack-based functional meat products.

The purpose of this mixed-methods study was to explore how medical secretaries experience digital transformation in a Swedish healthcare organisation, with a focus on workplace climate and health.

Data were collected using a sequential exploratory mixed-methods design based on grounded theory, with qualitative data collection (a Quality Café and individual interviews) followed by quantitative data collection (a questionnaire).

Four categories with seven underlying factors were identified, emphasising the crucial need for effective organisation of digital transformation. This is vital due to the increased knowledge and skills in utilising technology. The evolving roles and responsibilities of medical secretaries in dynamic healthcare settings should be clearly defined and acknowledged, highlighting the importance of professionality. Ensuring proper training for medical secretaries and other occupations in emerging techniques is crucial, emphasising equal value and knowledge across each role. Associations were found between some factors and the health of medical secretaries.

This study adds to the knowledge on digital transformation in healthcare by examining an important occupation. Most data were collected online, which may be a limitation of this study.

Several aspects of the medical secretaries’ experiences were identified. Knowledge of these is valuable for healthcare managers to make digital transformation more effective while avoiding excessive strain on medical secretaries.

Medical secretaries are expected to contribute to the digitalisation of healthcare. However, minimal research has been conducted on the role of medical secretaries in workplace digitalisation, focusing on workplace roles and its dynamics.

Relational contracting is increasingly being applied to complex and uncertain construction projects. However, it has proved hard to achieve stable performance and industry-level learning in this field. This paper employs an institutional perspective to analyze how legitimacy for relational contracting has been produced and challenged in Denmark, Finland, Norway and Sweden, including implications for dissemination and learning.

A collaborative case study design is used, where longitudinal accounts of the developments in relational contracting over more than 25 years in four Nordic countries were developed by scholars based in each country. The descriptions are underpinned by literature sources from research, practice and policy.

The countries share similar problem perceptions that have triggered the de-institutionalization of traditional contracting practices. Models and policies developed elsewhere are important sources of knowledge and legitimacy. Most countries have seen pendulum movements, where dissemination of relational contracting is followed by backlashes when projects fail to meet projected outcomes. Before long, however, relational contracting tends to re-emerge under new labels and in slightly new forms. Such a proliferation of concepts presents further obstacles to learning. Successful institutionalization is found to rely on realistic goals in combination with broad competence development at the organizational and industry levels.

In seeking inspiration from other countries, policymakers should go beyond contract models to also consider strategies to manage industry-level learning.

The paper provides a unique longitudinal cross-country perspective on the field of relational contracting. As such, it contributes to the small stream of literature on long-term institutional change in the construction sector.