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India liberalized its economy in 1991, which resulted in intense global competition, quality-conscious and demanding customers. Additionally, significant technological advancements lead to enhancements in products and processes. These forced Indian organizations to adopt innovative business strategies in the past 30 years. Meanwhile, the Lean Six Sigma methodology has significantly grown with vast applicability during the past 30 years. Thus, the purpose of this study is to develop the learning on Lean Six Sigma methodology in the Indian context through investigation of literature.

A three-stage systematic literature review approach was adopted to investigate the literature during the present study. In total, 187 articles published in 62 journals/conference proceedings from 2005 to 2022 (18 years) were shortlisted. The first part of the article summarizes the significant milestones towards the quality journey in the Indian context, along with the evolution of the Lean Six Sigma methodology. The second part examines the shortlisted papers on Lean Six Sigma frameworks, their applicability in industrial sectors, performance metrics, outcomes realized, publication trends, authorship patterns and leading researchers from the Indian perspective.

Lean Six Sigma has emerged as a highly acclaimed and structured business improvement strategy worldwide. The Indian economy has seen remarkable growth in the past decade and is one of the fastest-growing economies in the 21st century. Lean Six Sigma implementation in India has significantly increased from 2014 onward. The study revealed that researchers have proposed several different frameworks for Lean Six Sigma implementation, the majority of which are conceptual. Furthermore, the balanced applicability of Lean Six Sigma in manufacturing and service sectors was observed with the highest implementation in the health-care sector. Additionally, the widely adopted tools, techniques along with performance metrics exploring case studies were reported along with a summary of eminent and leading researchers in the Indian context.

This study is confined to reviewed papers as per the research criteria with a significant focus on the Indian context and might have missed some papers due to the adopted papers selection strategy.

The present study is one of the initial attempts to investigate the literature published on Lean Six Sigma in the Indian context, including perspective on the Indian quality movement. Therefore, the present study will provide an understanding of Lean Six Sigma methodology in the Indian context to graduating students in engineering and management and entry-level executives. The analysis and findings on Lean Six Sigma frameworks, research approach, publications details, etc., will be helpful to potential research scholars and academia. Additionally, analysis of case studies on Lean Six Sigma implementation by Indian industries will assist the managers and professionals in decision making.

The future increase of chronic diseases in the world requires new challenges in the health domain to improve patients' care from the point of view of the organizational processes, clinical pathways and technological solutions of digital health. For this reason, the present paper aims to focus on the study and application of well-known clinical practices and efficient organizational approaches through an innovative model (TALIsMAn) to support new care process redesign and digitalization for chronic patients.

In addition to specific clinical models employed to manage chronic conditions such as the Population Health Management and Chronic Care Model, we introduce a Business Process Management methodology implementation supported by a set of e-health technologies, in order to manage Care Pathways (CPs) digitalization and procedures improvement.

This study shows that telemedicine services with advanced devices and technologies are not enough to provide significant changes in the healthcare sector if other key aspects such as health processes, organizational systems, interactions between actors and responsibilities are not considered and improved. Therefore, new clinical models and organizational approaches are necessary together with a deep technological change, otherwise, theoretical benefits given by telemedicine services, which often employ advanced Information and Communication Technology (ICT) systems and devices, may not be translated into effective enhancements. They are obtained not only through the implementation of single telemedicine services, but integrating them in a wider digital ecosystem, where clinicians are supported in different clinical steps they have to perform.

The present work defines a novel methodological framework based on organizational, clinical and technological innovation, in order to redesign the territorial care for people with chronic diseases. This innovative ecosystem applied in the Italian research project TALIsMAn is based on the concept of a continuum of care and digitalization of CPs supported by Business Process Management System and telemedicine services. The main goal is to organize the different socio-medical activities in a unique and integrated IT system that should be sustainable, scalable and replicable.

This article aims to address the need for a more structured partnership between civilian and military healthcare, particularly in the context of cross-border threats in the EU. While both systems are driven by the same goal of providing high-quality healthcare services and achieving optimal patient outcomes, they operate under different national approaches and resources.

Two recent crises are presented as examples that highlight the necessity of cooperation between civilian and military medical systems. The Covid-19 Pandemic and the Ukrainian Conflict are described based on the experience gathered by the author as a member of the NATO Centre of Excellence for Military Medicine and form the base to shape a broader perspective on the future of civil-military interaction in healthcare at the European Union level.

The ability to deliver coordinated responses during crises depend on the level of interoperability, preparation and mutual understanding. To improve synergies, a structured partnership should be established, prioritizing common standards of care and shared best practices. Integrating military and civilian healthcare pathways can be especially beneficial in situations where patients are moved from the point of injury or sickness across different military and civilian structures to receive the most appropriate treatment and rehabilitation for their conditions.

The relationship between military and civilian healthcare systems is often discussed at multinational level, but a clear focus is lacking concerning their shared mission, distinct functions and potential for cross-border collaboration.

This study aims to explore the impact of environmental sustainability on government health expenditure in Africa for the period 2000–2021.

The study employs the generalized method of moments (GMM) technique and utilizes a sample of 43 African countries.

The study reveals that carbon dioxide (CO2) emissions and renewable energy consumption have a positive relationship with health expenditure. For the control factors, we demonstrate that economic growth, urbanization and industrialization have a significant negative influence on health expenditure, while the impact of education on health expenditure is positive.

The study proposes several policy recommendations, including prioritizing investment in renewable energy sources and promoting the use of cleaner energy sources such as wind, solar and hydroelectric power. These measures would help improve environmental quality and reduce government health expenditure.

The study contributes to the limited research on the relationship between environmental quality and health expenditure in Africa. Moreover, it goes beyond previous studies that only considered CO2 emissions and explores the impact of adopting cleaner energy sources on health expenditure.

Drawing on the conservation of resources theory and attachment theory, this paper proposes that employee–organization relationship and satisfaction with work–life balance mediate the influence of workplace attachment on service recovery performance.

Data collection was carried out through the distribution of questionnaires among a sample of healthcare providers from Lebanese private hospitals and analyzed via structural equation modeling.

The results indicate that workplace attachment has a significant impact on employee–organization relationship, satisfaction with work–life balance and service recovery performance. The findings further reveal that employee–organization relationship and satisfaction with work–life balance significantly influence service recovery performance and fully mediate the relationship between workplace attachment and service recovery performance.

This study is the first to investigate the mediating role of the employee–organization relationship and satisfaction with work–life balance between workplace attachment and service recovery performance. Over and above, this study is the first of its kind that the authors are aware of, being conducted in the healthcare sector, specifically in Lebanon. Based on the findings, the paper discusses the theoretical contributions, managerial implications and suggestions for further studies.

The childbirth process is a complex and vital event that requires careful analysis and improvement. This experience can shape a woman's perspective on motherhood and even affect her mental health. Healthcare providers must prioritize improving the birth experience for women. In this interdisciplinary research, a combination of business process modeling (BPM) and medicine have been used with the aim of realizing an improved delivery experience and increased maternal satisfaction.

The data collection of this study was done by observing 518 childbirth processes and interviewing the chief of labor, chief residents, and midwives in the obstetrics and gynecology department of a hospital in Tehran from October 2022 to February 2023.

The research has been done in four main stages. The first phase is to model the primary process and sub-processes of normal vaginal delivery (NVD). The second phase is validation using expert confirmation and process mining (PM). The third phase is the analysis of the causes of maternal dissatisfaction in labor. The fourth phase of the heuristics redesigning and improving the process, in which for the first time three new categories have been presented including hospital-based, patient-based, and medical technique-based results show BPM intervention effect can be far-reaching in improving patient care and optimizing operational efficiency.

This study is one of only a few to adopt a process-oriented perspective to show how BPM can be used in clinical processes and has specifically examined an essential clinical process, i.e. childbirth.

1. Developing business process management (BMP) applications in a medical special process related to childbirth as interdisciplinary research.

2. A combination of qualitative and quantitative techniques contains engineering software and management approaches for a Case study, Implementation of BPM lifecycle in the women's hospital in Iran, Tehran, for a clinical process, which is called, normal vaginal delivery (NVD) process for fetal expulsion normally.

3. Modeling NVD clinical process and sub-process for the first time by BPMN2.0 notations in visual paradigm (VP) software and Validation of the made model with process mining (PM), by Disco process mining software. This was done through event log collection from HIS at the hospital.

4. Improving the childbirth process by redesigning heuristics and Introducing two new categories special for clinical process improvement for the first time.

5. Clinical process improvement heuristics obtained in this research are not consistent with the previous seven categories presented in previous studies such as Marlon Dumas' book. Therefore, we have introduced two new heuristics to redesign clinical processes compatible with medical centers, including hospital-based, patient-based, and medical technique-based.

6. Providing a framework for clinical process modeling and improvement containing steps and tools.

Developing business process management (BMP) applications in a medical special process related to childbirth as interdisciplinary research.

A combination of qualitative and quantitative techniques contains engineering software and management approaches for a Case study, Implementation of BPM lifecycle in the women's hospital in Iran, Tehran, for a clinical process, which is called, normal vaginal delivery (NVD) process for fetal expulsion normally.

Modeling NVD clinical process and sub-process for the first time by BPMN2.0 notations in visual paradigm (VP) software and Validation of the made model with process mining (PM), by Disco process mining software. This was done through event log collection from HIS at the hospital.

Improving the childbirth process by redesigning heuristics and Introducing two new categories special for clinical process improvement for the first time.

Clinical process improvement heuristics obtained in this research are not consistent with the previous seven categories presented in previous studies such as Marlon Dumas' book. Therefore, we have introduced two new heuristics to redesign clinical processes compatible with medical centers, including hospital-based, patient-based, and medical technique-based.

Providing a framework for clinical process modeling and improvement containing steps and tools.

Mobile health (mHealth) technologies, in particular, have been sought after and advocated as a means of dealing with the pandemic situation. Despite the obvious advantages of mHealth, which include monitoring and exchanging health information via mobile applications, mHealth adoption has yet to take off exponentially. Expanding on the unified theory of acceptance and use of technology (UTAUT) model, this study aims to better comprehend consumers’ receptivity to mHealth even after the pandemic has subsided.

Through purposive sampling, data were collected from a sample of 345 mobile phone users and analysed using partial least squares structural equation modelling (PLS-SEM) and artificial neural networks (ANN) capture both linear and nonlinear relationships.

Effort expectancy, performance expectancy, social influence, pandemic fear and trustworthiness positively influenced mHealth adoption intention, with the model demonstrating high predictive power from both the PLSpredict and ANN assessments.

The importance–performance map analysis (IPMA) results showed that social influence had great importance for mHealth uptake, but demonstrated low performance.

Referrals are an alternative that policymakers and mHealth service providers should think about to increase uptake. Overall, this study provides theoretical and practical insights that contribute to the advancement of digital healthcare, aligning with the pursuit of Sustainable Development Goal 3 (SDG 3) (good health and well-being).

This study has clarified both linear and nonlinear relationships among the factors influencing intentions to adopt mHealth. The findings from both PLS and ANN were juxtaposed, demonstrating consistent findings.

The global population has been experiencing an unprecedentedly rapid demographic transition as the populations have been growing older in many countries during the current decades. The purpose of this study is to introduce a Grey Exponential Smoothing model (GESM)-based mechanism for analyzing population aging.

To analyze the aging population of Sri Lanka, initially, three major indicators were considered, i.e. total population, aged population and proportion of the aged population to reflect the aging status of a country. Based on the latest development of computational intelligence with Grey techniques, this study aims to develop a new analytical model for the analysis of the challenge of disabled and frail older people in an aging society.

The results suggested that a well-defined exponential trend has been seen for the population ages 65 and above, a total of a million) during 1960–2022; especially, the aging population ages 65 and above has been rising rapidly since 2008. This will increase to 24.8% in 2040 and represents the third highest percentage of elderly citizens living in an Asian country. By 2041, one in every four Sri Lankans is expected to be elderly.

The study proposed a GESM-based mechanism for analyzing the population aging in Sri Lanka based on the data from 1960 to 2022 and forecast the aging demands in the next five years from 2024 to 2028.

This study aims to investigate the combined use of System Dynamics (SD) applications in Enterprise Engineering (EE) research and practice. SD application in EE is becoming widely accepted as a tool to support decision-making processes and for capturing relationships within enterprises.

A systematic literature review (SLR) is conducted using a standard SLR method to provide a comprehensive review of existing literature. The search was conducted on ten platforms identifying 30 publications which were analysed through the use and development of a codebook.

The SLR showed that 90% of the result set consisted of peer-reviewed academic conferences and journal papers. The SLR identified a highly dispersed author set of 83 authors. Amongst these authors, Vinay Kulkarni was an active author who has co-authored up to four publications in this research area. The analysis further revealed that the combined use of SD applications and EE is an emerging research area that still needs to develop in maturity. While all phases of EE have received attention, the current research work is more focused on the design phase. The important gap between model development and implementation is identified.

The study elucidates the existing status of interdisciplinary research combining techniques from the SD and EE disciplines, suggesting future research topics that combine the strengths of these existing disciplines.

The purpose of this systematic review is to critically analyze pharmaceutical industry case studies on the implementation of Lean 4.0 methodologies to synthesize key lessons, benefits and best practices. The goal is to inform decisions and guide investments in related technologies for enhancing quality, compliance, efficiency and responsiveness across production and supply chain processes.

The article utilized a systematic literature review (SLR) methodology following five phases: formulating research questions, locating relevant articles, selecting and evaluating articles, analyzing and synthesizing findings and reporting results. The SLR aimed to critically analyze pharmaceutical industry case studies on Lean 4.0 implementation to synthesize key lessons, benefits and best practices.

Key findings reveal recurrent efficiency gains, obstacles around legacy system integration and data governance as well as necessary operator training investments alongside technological upgrades. On average, quality assurance reliability improved by over 50%, while inventory waste declined by 57% based on quantified metrics across documented initiatives synthesizing robotics, sensors and analytics.

As a comprehensive literature review, findings depend on available documented implementations within the search period rather than direct case evaluations. Reporting bias may also skew toward more successful accounts.

Synthesized implementation patterns, performance outcomes and concealed pitfalls provide pharmaceutical leaders with an evidence-based reference guide aiding adoption strategy development, resource planning and workforce transitioning crucial for Lean 4.0 assimilation.

This systematic assessment of pharmaceutical Lean 4.0 adoption offers an unprecedented perspective into the real-world issues, dependencies and modifications necessary for successful integration, absent from conceptual projections or isolated case studies alone until now.