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Inpatient colonoscopy bowel preparation quality is frequently suboptimal. This quality improvement (QI) intervention is focused on regimenting this process to impact important outcomes.

Define, Measure, Analyze, Improve and Control (DMAIC) methodology was employed, including generating a root-cause analysis to identify factors associated with inpatient bowel quality. These findings motivated the creation of a standardized electronic health record (EHR)-based order set with consistent instructions and anticipatory guidance for administering providers.

There were 264 inpatient colonoscopies evaluated, including 198 procedures pre-intervention and 66 post-intervention. The intervention significantly improved the adequacy of right colon bowel preparations (75.0 percent vs 86.9 percent, p = 0.04) but not overall preparation quality (73.7 percent vs 80.3 percent, p = 0.22). The intervention led to numerical improvement in the proportion of procedures in which the preparation quality interfered with making a diagnosis (10 percent–6 percent, p = 0.29) or resulted in an aborted procedure (3.5 percent–1.5 percent, p = 0.39). After the intervention, provider satisfaction with the ordering process significantly increased (23.3 percent vs 61.1 percent, p < 0.001).

The QI intervention significantly reduced the number of inpatient colonoscopies with inadequate preparation in the right colon, while also modestly improving the diagnostic yield and proportion of aborted procedures. Importantly, the standardized EHR order set substantially improved provider satisfaction, which should justify broader use of such tools.

Novel clinical outcomes such as ability to answer diagnostic questions were improved using this intervention. The results align with strategic goals to enhance provider experience and continuously improve quality of patient care.

This article aims to analyze the relationship between the Norwegian Noark Standard and the concepts of Open Government and Freedom of Information (FOI). Noark is the Norwegian model requirements for Electronic Documents and Records Management Systems (EDRMS). It was introduced in 1984, making it not only the world’s first model requirement for EDRMS but also, through the introduction of versions from Noark 1 to the present Noark 5, internationally the model requirement with the longest continuation of implementation.

To better understand the technical outline and functionality of the Noark Model requirements, it is necessary to see the connection to the wider framework of the Norwegian governance legislation and its FOI Act (Norway, Freedom of Information Act, 2006) on the right of access to documents held by the public administration and public undertakings. FOI is the foundation on which the Norwegian Open Government platform (OEP) rests, as it aims to increase openness and transparency in the Norwegian society. Being one of the first national initiatives to incorporate in a single platform an up-to-date nationwide registry of metadata deriving from the EDRMS of the governmental sector, OEP is a model which could have relevance in open government settings also outside of Norway.

Non-fixity and randomness in the registering of metadata decrease the possibility of systematic search and systematic retrieval, since search within records presumably requires a combination of two or more sets of metadata. Context is a crucial component in information retrieval from records, and no records contain only one metadata element. With few exceptions, a record relates to another record, and the relation between the two of them is in itself a set of metadata. If the metadata relating the two records does not follow a standardized format, retrieval possibilities will remain random. The unpredictability following inadequate search results will decrease the credibility and the trust factor which should lie imminent within the information system. The absence of adequate search results will lead to an immediate decrease in the public’s perception of the system being valid or relevant as a trusted source of information. If metadata within a governmental agency is known to be subject to non-authorised alterations, deletion on changes, trust in the authenticity and integrity of the information provided from the agency will decrease significantly. This subsequently decreases predictability in the retrieval of information within the EDRMS. The parameters securing non-alteration of metadata once locked in the Noark-compliant EDRMS, may be measured against the absence of the same in any system being compared.

An adequate analysis describing the principles of trust embedded in the weekly or daily dissemination of metadata from the Noark databases to the OEP somehow has to explain certain parameters. These parameters within the Noark requirements eliminate the possibility of unauthorised deletion, alteration or manipulation of metadata and documents in the databases of the governmental organisations. The combination of parameters also creates context. The metadata transferred from the Noark systems to the OEP platform may never have been stored within a trusted digital repository. Transfer to the OEP happens weekly, whilst transfer to the repository of The National Archives is performed far less seldom – perhaps every tenth year. The contents of the Noark-based systems are not stored in trusted digital repositories in the governmental agencies, but remain part of the ordinary grid of servers and databases.

The purpose of this paper is to test and measure the outcome of a community hospital in implementing the Affordable Care Act (ACA) through a co-management arrangement. RQ1: do the benefits of a co-management arrangement outweigh the costs? RQ2: does physician alignment aid in the effective implementation of the ACA directives set for hospitals?

A case study of a 350-bed non-profit community hospital co-management company. The quantitative data are eight quarters of quality metrics prior and eight quarters post establishment of the co-management company. The quality metrics are all based on standardized national requirements from the Joint Commission and Centers for Medicare and Medicaid Services guidelines. These measures directly impact the quality initiatives under the ACA that are applicable to all healthcare facilities. Qualitative data include survey results from hospital employees of the perceived effectiveness of the co-management company. A paired samples difference of means t-test was conducted to compare the timeframe before co-management and post co-management.

The findings indicate that the benefits of a co-management arrangement do outweigh the costs for both the physicians and the hospital (RQ1). The physicians benefit through actual dollar payout, but also with improved communication and greater input in running the service line. The hospital benefits from reduced cost – or reduced penalties under the ACA – as well as better communication and greater physician involvement in administration of the service line. RQ2: does physician alignment aid in the effective implementation of the ACA directives set for hospitals? The hospital improved in every quality metric under the co-management company. A paired sample difference of means t-test showed a statistically significant improvement in five of the six quality metrics in the study.

Previous research indicates the potential effectiveness of co-management companies in improving healthcare delivery and hospital-physician relations (Sowers et al., 2013). The current research takes this a step further to show that the data do in fact support these concepts. The hospital and the physicians carrying out the day-to-day actions have shared goals, better communication, and improved quality metrics under the co-management company. As the number of co-management companies increases across the USA, more research can be directed at determining their overall impact on quality care.

The purpose of this paper is twofold: first, a case study on the application of lean production principles in a manufacturing facility is presented to demonstrate the impact of frequent and systematic use of a Kaizen event on quality and delivery performance. Second, the detailed description and analysis of the Kaizen event and its impact are provided, including a comprehensive analysis of the role of Kaizen events on employee participation and motivation.

The study utilizes a Kaizen event’s case study data with the help of various waste detection and elimination tools and techniques. Changes in overall productivity along with potential long-term improvements in the delivery process are also analyzed and documented.

Pre- and post-quality measures are provided to demonstrate the results of the event on the production quality and on the performance of the overall manufacturing processes. Qualitative findings regarding performance measurements and the impact on the employees are reported.

The Kaizen team applied analytical techniques to one manufacturing site in North America of a company that has a manufacturing presence in 20 different countries.

Kaizen studies involving packaging operations are quite limited. This study fills this gap by detailing the Kaizen event implementation in a packaging delivery and dispensing systems manufacturer for the cosmetic industry. The implementation of this Kaizen event is detailed along with the data and techniques utilized for process improvement. The study also reports findings regarding the impact of the Kaizen event on employee participation.

This study examines the roles of organizational justice and trust in a specific type of management control system (MCS), gain-sharing. According to the proposed theory, employee perceptions involving the procedural and distributive justice of the gain-sharing plan influence employee trust in managers. Positive perceptions of fairness lead to high trust, which, in turn has positive consequences for the organization such as lower employee turnover. To investigate these issues, a survey was administered to employees of a large manufacturing company. Results of structural equation modeling indicate that employee perceptions regarding the fairness of the gain-sharing plan are positively related to employee trust in managers. Further, trust is linked to employee turnover intentions. The results imply that the organizational justice of an MCS has consequences for the attitudes and behaviors of employees and thus the success or failure of the MCS.

Purpose – Health information technology (HIT) has been lauded as a foundation upon which the development of an integral solution to cost and quality problems facing many nations is predicated. Countries throughout the world have taken differing approaches in their efforts to advance that foundation through policy, financial, and cultural systems that come to support or hinder adoption. As we explore potential opportunities to learn from the experience of others, we pause to consider the environmental, regulatory, financial, and social dynamics that define the US context.

Design/methodology/approach – This chapter outlines the framework for a comparative approach through four dimensions – environmental, regulation, financial, and social – through which comparative HIT studies should be explored.

Findings – With such markedly different contexts in which their HIT is embedded, it is important to not simply look at other countries as a yardstick upon which we compare our failures and successes. Rather, we must look critically at these examples understanding that the dynamics at play in each context have created opportunities and obligations that have come to define each country's implementation.

Originality/value – The need for a common framework through which scholars can explore comparative HIT systems, while remaining grounded in the US context is an important aspect of effective knowledge translation in adoption.

This paper reviews the literature on internationalization barriers of small and medium enterprises (SMEs) from developing countries. The purposes of the study are: (1) to explicitly point out specific factors influencing the growth and internationalization of SMEs from developing countries and (2) to identify the research gaps to provide lucid and succinct directions for future research in this area.

The authors selected relevant papers from journals listed on Web of Science and Scopus databases.

It was found that there are large number of questions remain unanswered regarding the internationalization of SMEs from developing countries regarding the factors determining their growth and internationalization.

This review distinctively accentuates previous studies on such barriers influencing the growth of SMEs from developing countries and systematically synthesize the issues faced by those SMEs. Thus, the authors seek to provide a comprehensible platform for researchers working in this area.

Green Lean Six Sigma (GLSS) is a comprehensive approach that aims to reduce waste, emissions and non-value added activities, thus mark an effective impact on sustainability of firms. Despite the numerous benefits of GLSS implementation, it is evident that Micro Small and Medium Enterprises (MSMEs) are still struggling to understand, integrate and implement this strategy. This research work provides a comprehensive analysis of GLSS within MSMEs and proposes a conceptual integration framework of GLSS for improving economic and environmental dimensions of sustainability MSMEs.

A systematic literature review (SLR) methodology was planned to assess and analyse the research articles from 2007 to 2022. Different key elements of GLSS such as barriers, enablers and tool sets have been thoroughly reviewed and analysed for MSME organisations to understand their behaviour and effectively adopt the GLSS approach in their operations.

This study provides the analysis of different perspectives of GLSS and this will contribute to improve different metrics related to emissions and quality in MSMEs. It provides MSMEs industrial managers with a comprehensive knowledge base of GLSS elements, enabling effective deployment.

The present study provides a significant knowledge base and know-how of GLSS to researchers that will assist in deploying this sustainable approach in different industrial domains. The study also assists industrial managers by providing a systematic framework of GLSS for MSMEs. Further, the study also supports society by proving pathway to improve the environmental dynamics through the execution GLSS.

The study is of the first kind that review different facets of GLSS related to MSME. The study not only enhances theoretical know how of GLSS but also guides practitioners how to implement comprehensive GLSS program for improved environmental sustainability.

Addresses the standardization of the measurements and the labels for concepts commonly used in the study of work organizations. As a reference handbook and research tool, seeks to improve measurement in the study of work organizations and to facilitate the teaching of introductory courses in this subject. Focuses solely on work organizations, that is, social systems in which members work for money. Defines measurement and distinguishes four levels: nominal, ordinal, interval and ratio. Selects specific measures on the basis of quality, diversity, simplicity and availability and evaluates each measure for its validity and reliability. Employs a set of 38 concepts ‐ ranging from “absenteeism” to “turnover” as the handbook’s frame of reference. Concludes by reviewing organizational measurement over the past 30 years and recommending future measurement reseach.

Aim of the present monograph is the economic analysis of the role of MNEs regarding globalisation and digital economy and in parallel there is a reference and examination of some legal aspects concerning MNEs, cyberspace and e‐commerce as the means of expression of the digital economy. The whole effort of the author is focused on the examination of various aspects of MNEs and their impact upon globalisation and vice versa and how and if we are moving towards a global digital economy.