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The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.

The methodology entails the integration of service design (SD) and action research (AR) methodologies, characterized by iterative phases that systematically alternate between action and reflective processes, fostering cycles of change and learning. Within this framework, stakeholders are engaged through semi-structured interviews, while the existing and envisioned processes are delineated and represented using BPMN 2.0. These methodological steps emphasize the development of an autonomous, patient-centric web application alongside the implementation of an adaptable and patient-oriented scheduling system. Also, business processes simulation is employed to measure key performance indicators of processes and test for potential improvements. This method is implemented in the context of the CP addressing transient loss of consciousness (TLOC), within a publicly funded hospital setting.

The methodology integrating SD and AR enables the detection of pivotal bottlenecks within diagnostic CPs and proposes optimal corrective measures to ensure uninterrupted patient care, all the while advancing the digitalization of diagnostic CP management. This study contributes to theoretical discussions by emphasizing the criticality of process optimization, the transformative potential of digitalization in healthcare and the paramount importance of user-centric design principles, and offers valuable insights into healthcare management implications.

The study’s relevance lies in its ability to enhance healthcare practices without necessitating disruptive and resource-intensive process overhauls. This pragmatic approach aligns with the imperative for healthcare organizations to improve their operations efficiently and cost-effectively, making the study’s findings relevant.

Digital transformation (DT) harnessing the potential of emerging technology creates opportunities and challenges for organizations worldwide. Senior executives view DT as a key initiative for future competitiveness, a view shared by academic researchers. What may challenge the organization is that the vision may be present while preparedness may be lacking. Organizational preparedness depends on managers and employees charged with implementing DT and their perceptions on preparedness are often not aligned with senior executives.

In this research, the authors explore the perceptions of managers and employees on DT preparedness in an organization by gathering data from 579 participants. This study uses an innovative approach to qualitative data analysis using interactive topic modeling.

Findings in this qualitative study provide valuable insights on the perceptions of these individuals and helps understand (a) how they view DT preparedness and (b) may behave in this context. In general DT is well understood, however managers are not keen to change work processes to take advantage of the new digital tools and there appears that generational gap is a barrier to successful DT.

Senior executives play a central role communicating the DT vision necessary to inspire managers and employees. As organizations continue to invest large sums of money to explore value creation for customers and stakeholders by leveraging digital technologies, the information systems (IS) discipline can take the lead by asking the question, what can be done to improve the understanding of DT implementation in an organization?

This study focuses on the triadic multilevel psychic distance (MPD) between the firm, target market and bridge-maker and its consequences for firm internationalization. Specifically, it spotlights the triadic psychic distance between firms, the levels of psychic distance in the target market (country and business) and the bridge-maker. Therefore, this study examines the triadic MPD among these three entities and its impact on firm internationalization.

This study uses qualitative and case study research approaches. It is based on 8 case companies and 24 internationalization cases. Secondary data were collected, and interviews with bridge-makers and industry experts were conducted.

The study found that MPD appeared in the triad. The MPD between firms and markets is related to country-specific differences and business difficulties. The MPD between the firm and the bridge-maker is based on the latter’s lack of knowledge vis-à-vis bridging the firm’s MPD. Finally, the MPD between bridge-makers and the market is based on the former’s lack of knowledge of the home country’s business difficulties.

This is the first study to develop and adopt a triadic multilevel psychic distance conceptualization that provides evidence for and sheds light on the triadic MPD and its effect on firm internationalization. This study identifies the reasons behind triadic MPD in connection to firm internationalization. Notably, firm internationalization is interdependent on the triadic MPD setting between the firm, bridge-maker and target market. It has theoretical value and contributes to the recent advancement in the understanding of MPD in international marketing literature.

The purpose of this study was to explore how transport companies in Uganda execute strategies in a turbulent business environment.

The study adopted an exploratory qualitative methodology using the data collected through an open-ended instrument. Utilizing the qualitative data analysis software QSR NVivo9, the data were analyzed following the Gioia's methodology. Verbatim texts were used to explain the emergent themes.

The study's findings show that to successfully execute strategies, companies in Uganda communicate, coordinate and put control systems in their operations. The activities undertaken include customer care, timely settlement of complaints, comfortable seats, playing local music, partnerships with reliable fuel stations, setting up strategic offices, cost management, use of experienced drivers, sub-renting vehicles and inspections.

The study produces a pioneering result of how transport companies execute strategies in a turbulent business environment, an aspect that has not been adequately highlighted in previous studies.

The paper aims to examine the role played by property tax in influencing strategic decisions regarding marital separation and divorce in Italian municipalities.

The empirical analysis is conducted on a sample of 6,458 Italian municipalities by applying the ordinary least squares (OLS) and instrumental variables (IVs) approaches.

The estimation results show a small increase in marital separations and divorces as the difference between the municipal secondary and primary home tax rate increases. Specifically, an increase of 1‰ in the property tax rate differentials is accompanied by an increase of six marital separations and four divorces per 1,000 inhabitants.

The main limitation of the analysis is that the strategic behavior of the married couple is inferred from econometric analysis with data aggregated at the municipal level. To investigate this phenomenon more precisely, it would be useful to have individual data collected by surveys on strategic divorce decisions due to property tax incentives.

This study contributes to the scant existing literature on the tax incentives for strategic divorce. It is the first study to empirically investigate the effects of property tax on separation and divorce decisions by investigating the Italian context. In Italy, a property tax was introduced in 1993, encouraging “false” divorces by spouses with a second home since the tax on the secondary home was set at a rate higher than that on the primary residence. Moreover, there were no tax deductions and no additional tax breaks on the secondary home, while they were established on the primary one. Higher property taxes and the absence of tax breaks on the secondary home may have encouraged a strategic behavior whereby many married couples filed for false separation and divorce in order to recover part of property tax rebates.

The paper aims is to see why social conflict caused by class segregation did not occur in Gading Serpong? What factors prevent conflict from occurring? This research seeks to find the causes of the nonoccurrence of social conflict due to class segregation in the Gading Serpong cluster area and explore the factors that restrain conflict there.

This research is qualitative research with data collection techniques through in-depth interviews with several parties identified as brokerages in the research object area. In this context, one of the media and analytical tools is to recognize agents or brokers who connect two groups of people. Brokerage occurs in sectors, patterns or forms of informal, personal relationships; to understand it, one must pay close attention to micro-level relationships and social psychological processes. However, brokerage can have a significant impact on macro-level social relations, as it is generally associated with social integration processes.

The lack of involvement of developers in overcoming social conflicts that occur between Gading Serpong natives and migrants in Gading Serpong housing has given rise to new actors. These new actors are what we can call brokers, where they have a role as brokers who are able to connect between migrants and natives in the Gading Serpong area. The broker phenomenon is actually familiar in academia, where in practice the broker acts as someone who is able to find solutions to problems. The broker is the reason even social segregation is created between migrant citizens and native citizens in Gading Serpong but never becomes a conflict between them.

Even if the brokerage phenomenon is the reason why there is no conflict over social segregation brokerage is not the only factor in this nonconflict segregation. Therefore, to cover the larger area of these suburban segregation problems, there must be further research on this topic.

The practical implication of this research is to encourage the housing developers that create urban housing, such as clusters or other gated communities, to evaluate the social factors, such as potential segregation and conflict management. Also to encourage the developers to get involved and create some social engineering systems, like brokerage, market and other social agents, to create some nonconflict segregation or even more inclusive communities.

This research is uncovering the main reason why social segregation between migrant and native people in Gading Serpong, which could potentially lead to conflict, is never a conflict. The main reason is social actors like brokerage.

Strategic flexibility (SF) has become increasingly important for firms because of the fast changes in the external environment. In line with the practical importance of SF, an emerging research field has developed around it that has attempted to understand the nature of SF and the key relationships. The aim of this study is to unveil the semantic structure of the recent literature on SF and to suggest new promising areas for future research.

The authors conduct a systematic literature review with a bibliographic analysis technique, which allows authors to identify the main recent streams in the literature, as well as offer reflections and suggestions for future research.

The authors uncover three main emerging areas in the research on SF, namely SF as a dynamic capability, the role of knowledge management for SF and the relationship between a firm SF and the external environment. The authors put forward three avenues for future research on SF: Avenue 1. SF, business model innovation (BMI) and other dynamic capabilities (DC), Avenue 2. Digital technologies and SF/organizational agility and Avenue 3. SF and sustainability. Articles included in the special issue entitled “A strategic perspective on flexibility, agility and adaptability in the digital era” contribute to Avenue 2, thus paving the way for filling some of the identified gaps regarding the relationship between SF and digitalization.

To the best of authors’ knowledge, this is the first literature review on SF that uses a bibliometric approach to draw conclusions on the findings in the literature. The review contributes to the theoretical understanding of SF by illustrating and explicating core topics that have persisted over time, as well as by presenting three main avenues for further developing authors’ knowledge around SF.

Output from the Irish Dairy Industry has grown rapidly since the abolition of quotas in 2015, with processors investing heavily in capacity expansion to deal with the extra milk volumes. Further capacity gains may be achieved by extending the processing season into the winter, a key enabler for which being the reduction of duration of the winter maintenance overhaul period. This paper aims to investigate if Lean Six Sigma tools and techniques can be used to enhance operational maintenance performance, thereby releasing additional processing capacity.

Combining the Six-Sigma Define, Measure, Analyse, Improve, Control (DMAIC) methodology and the structured approach of Turnaround Maintenance (TAM) widely used in process industries creates a novel hybrid model that promises substantial improvement in maintenance overhaul execution. This paper presents a case study applying the DMAIC/TAM model to Ireland’s largest dairy processing site to optimise the annual maintenance shutdown. The objective was to deliver a 30% reduction in the duration of the overhaul, enabling an extension of the processing season.

Application of the DMAIC/TAM hybrid resulted in process enhancements, employee engagement and a clear roadmap for the operations team. Project goals were delivered, and original objectives exceeded, resulting in €8.9m additional value to the business and a reduction of 36% in the duration of the overhaul.

The results demonstrate that the model provides a structure that promotes systematic working and a continuous improvement focus that can have substantial benefits for wider industry. Opportunities for further model refinement were identified and will enhance performance in subsequent overhauls.

To the best of the authors’ knowledge, this is the first time that the structure and tools of DMAIC and TAM have been combined into a hybrid methodology and applied in an Irish industrial setting.

Previous studies show that the implementation of gender equality encounters resistance in military organizations, but it is often invisible or seen as confined to anonymous structures or troubled individuals. This paper aims to show how the Swedish Armed Forces (SAF) use organizational principles to resist implementing gender equality measures.

The study is a qualitative analysis of discursive strategies in the SAF’s 2013–2018 annual reports to government.

The organizing principles of instrumentality and distance, while existing in parallel with gender equality efforts, actually pursue logics that prevents the SAF from implementing gender equality. The principle of instrumentality in this context means that gender equality in the SAF is of secondary interest to organizational members. The principle of distancing from the problem includes strategies that alienate female from male officers.

The contribution of this paper is the finding that the use of organizing principles represents conscious organizational resistance to gender equality efforts. This kind of use needs to be revealed and criticized to change military organizations.

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.