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The expansion of online shopping aligned with challenging economic conditions has contributed to increasing fraudulent retail product returns. Retailers employ numerous interventions typically determined by embedded perspectives within the company (supply side) rather than consumer-based assessments of their effectiveness (demand side). This study aims to understand how customers evaluate counter-fraud measures on opportunistic returns fraud in the UK. Based on the fraud triangle and the theory of planned behaviour, we develop an empirically informed framework to assist retail practice.

We collected 485 valid survey responses about consumer attitudes regarding which interventions are effective against different types of returns fraud. First, a principal component section evaluates the policies' effectiveness to identify any policy grouping that could help prioritise specific sets of policies. Second, cluster analysis follows a two-stage approach, where cluster size is determined, and then survey respondents are partitioned into subgroups based on how similar their beliefs are regarding the effectiveness of anti-fraud policies.

We identify policies relating to perceived effectiveness of interventions and create customer profiles to assist retailers in conceptualising potential opportunistic fraudsters. Our product returns fraud framework adopts a consumer perspective to capture the perceived behavioural control of potential fraudsters. Results suggest effectiveness of different types of interventions vary between different types of consumers, which leads to the development of propositions to combat the fraud.

This study is unique in assessing the perceived effectiveness of a range of interventions based on data collection and advanced analytics to combat fraudulent product returns in omnichannel retail.

Workflow optimisation is crucial for establishing a viable acute stroke (AS) intervention programme in a large tertiary care centre. This study aims to utilise Lean Six Sigma (LSS) principles to enhance the hospital's workflow.

The Action Research methodology was used to implement the project and develop the case study. The study took place in a large tertiary care academic hospital in India. The Define-Measure-Analyse-Improve-Control approach optimised the workflow within 6 months. Lean tools such as value stream mapping (VSM), waste audits and Gemba were utilised to identify issues involving various stakeholders in the workflow. Sigma-level calculations were used to compare baseline, improvement and sustainment status. Additionally, statistical techniques were effectively employed to draw meaningful inferences.

LSS tools and techniques can be effectively utilised in large tertiary care hospitals to optimise workflow through a structured approach. Sigma ratings of the processes showed substantial improvement, resulting in a five-fold increase in clinical outcomes. Specifically, there was a 43% improvement in outcome for patients who underwent acute stroke revascularisation. However, certain sigma ratings deteriorated during the control and extended control (sustainment) phases. This indicates that ensuring the sustainability of quality control interventions in healthcare is challenging and requires continuous auditing.

The article presents a single case study deployed in a hospital in India. Thus, the generalisation of outcomes has a significant limitation. Also, the study encounters the challenge of not having a parallel control group, which is a common limitation in quality improvement studies in healthcare. Many studies in healthcare quality improvement, including this one, are limited by minimal data on long-term follow-up and the sustainability of achieved results.

This study pioneers the integration of LSS methodologies in a large Indian tertiary care hospital, specifically targeting AS intervention. It represents the first LSS case study applied in the stroke department of any hospital in India. Whilst most case studies discuss only the positive aspects, this article fills a critical gap by unearthing the challenges of applying LSS in a complex healthcare setting, offering insights into sustainable quality improvement and operational efficiency. This case study contributes to the theoretical understanding of LSS in healthcare. It showcases its real-world impact on patient outcomes and process optimisation.